In 1558, John Knox penned The First Blast of the Trumpet Against the Monstrous Regiment of Women. Knox, a Protestant, was lamenting the fact that the Protestant Reformation was being stymied in both England and Scotland by Catholic monarchs. Yet it wasn’t their Catholicism that he blamed; it was the fact that they were women.

Knox used “monstrous” and “regiment” in an archaic sense to mean “unnatural” and “rule,” arguing that female dominion over men was against God and nature. He lamented that the future of the Protestant faith lay solely in the hands of a female monarchy largely hostile to its precepts. Echoing the era’s widespread assumption that women were inferior to men, capable only of domestic acts such as bearing children, Knox placed blame on the “abominable empire of wicked women” for the trials and tribulations of the Reformation.

No doubt it made perfect sense to Knox and his readers, but from our vantage point in the 21st Century, it’s easy to see that it was misogyny pure and simple. Women who dared seek more out of life than reproduction (or, as the in the case of queens, were forced by circumstance to do so) were unnatural and therefore monstrous. “Natural” women were meant to be home pregnant, breastfeeding or both.

There is a gathering backlash to the philosophies of natural childbirth and lactivism that condemn women who make different choices as “unnatural.”

Curiously, the injunction to limit oneself to natural pursuits applied only to women. Men who sought to do more than reproduce and hunt to feed themselves and their families — men who sailed ships, waged technological warfare, built cathedrals, wrote religious tomes — were to be praised for rising above their base, animal nature.

Sadly, contemporary midwives and lactation consultants are the intellectual heirs of Knox’s misogyny. Women who refuse to be limited by biology in giving birth to and feeding their infants in the “natural” way are portrayed as monstrous — either lacking in feminine feeling, possessing deficient bodies, too stupid (in need of “education” and “support”) to know better or all three.

Knox meant The Monstrous Regiment of Women as a marketing tool. He was selling his services as a Protestant reformer by tying the old religion of Catholicism to the “unnatural” rule of women. Those who let themselves be led by women were being led to Hell. Better to be led by men who know the way to Heaven.

Midwives and lactation consultants are also selling their services. They do so by tying the lifesaving technology of modern medicine — epidurals, C-sections and infant formula — to “unnatural” women. Indeed the technology itself is portrayed as male and patriarchal despite the fact that in 2018 the majority of obstetricians are women and the majority of women happily avail themselves of that technology. In other words, those who let themselves be led by technology are being led to the hell of a traumatic birth or a child sickened by lack of breastmilk. Better to be led by women, midwives and lactation consultants, who know the way to the heaven of empowering birth and empowering breastfeeding.

When midwives claim that the only healthy, safe birth (and not coincidentally the only one they can provide) is birth as nature intended, they are implying that women who choose otherwise are monstrous. When lactation consultants insist that we can’t improve upon breastfeeding (not coincidentally the only form of feeding they are selling) because it’s natural, they are implying that women who choose otherwise are monstrous.

Things didn’t turn out well for John Knox. Shortly after The Monstrous Regiment of Women was published, the Catholic, English Queen Mary died and was succeeded by the Protestant Queen Elizabeth. She was familiar with his condemnation of “unnatural” women and she wasn’t amused.

Though not the intended target of Knox’s First Blast, Queen Elizabeth took great offense at the publication, and in 1559, repeatedly refused Knox passage to Scotland through England. Knox attempted to apologize to the queen …

Ultimately he was allowed to return and he had learned his lesson:

Having endured the controversy of The First Blast, Knox went on to play a key role in Scotland’s opposition to the Catholic monarchy, solidifying Scotland as a Protestant, and Presbyterian, nation for centuries to come. As for his second and third blasts, it would seem that the “Trumpet of the Scottish Reformation” learned an important lesson. Neither was ever sounded.

He never stopped being a misogynist, but at least he stopped writing about it.

Midwives and lactation consultants need to learn the same lesson. It’s a very bad idea to criticize the people on whom you depend for employment. There is a gathering backlash to the philosophies of natural childbirth and lactivism, philosophies that condemn women who make different choices as “unnatural.” That backlash comes as women recognize that midwives and doulas aren’t leading them to heaven, but rather to a hell of excruciating labor pain, frustrating breastfeeding attempts that harm their babies, and being relegated back into the home.

Elizabeth, a subtle and brilliant queen, resented the misogyny of labeling her as “unnatural” because she chose to rule rather than to marry. Similarly, ever more women are coming to resent the misogyny of midwives and lactation consultants who seek to control women by labeling those who use and even choose technology by labeling them as “unnatural,” too. Admonishing women to pursue the natural has always been a hallmark of misogyny; it was true in 1558 and it’s just as true in 2018.

I won’t take the time to respond to all the comments because there are too many and quite a few of them twisted my words out of context and/or made assumptions and responded to those assumptions rather than my actual comments. I do want to thank a few people who responded thoughtfully, and I want to say that I did learn something here, which was my hope, though it sort of devolved into something akin to trying to have a discussion about abortion with “pro-life” folks who insist that the pro-choice movement is pro-abortion. Just because I had a natural birth does NOT mean I would ever say that every woman should have a natural birth. I support every woman’s right to choose whatever (in so much as we actually have control over a situation which is generally wildly unpredictable, scheduled induction/sections aside) type of labor she feels is best for her and her baby. The same as I support a woman’s right to make any other decisions about her reproductive health.

I have never personally felt pressured to have a natural birth for any reason, as the original post discusses, so it was a new idea to me that women would feel this way (there’s no need to hurl insults at me for this, I simply haven’t had that experience). I was more rough than intended in my initial comment, and I apologize for insulting the MD who wrote the original post; this was my first exposure to a community who so thoroughly opposes doulas and midwives and natural birth, and the one-sidedness of the original post set me off. I also did not realize how poorly regulated non-traditional birth providers are in other states as the one I live in has pretty strict regulations. Lastly, although many of you were effectively using stories to yell at me and tell me how much I suck, I appreciate all of the experiences and stories that everyone shared about their own birth experiences or those of women they know, and it’s awesome that many of them were good or positive.

So I learned that many women feel pressured about natural birth, and while I still don’t agree with some aspects of the original post, I can respect that there are many women here who had these feelings and are validating the story told by Dr. Amy. At the same time that those women are feeling pressured to pursue natural childbirth, others who have chosen to have a natural birth often have to fight tooth and nail to even have the opportunity to follow-through with natural childbirth in the traditional medical setting, so many of them turn to outside providers who in many cases do not have much training or a great safety record. Those who pursue natural birth feel that many physicians and/or hospital policies discourage this pursuit, feelings which have been validated by many women I know who had these experiences. The discussion then has shed some light for me on a full circle of misogyny, where a pregnant women essentially cannot avoid misogyny from at least one side when making decisions about her labor. Damn.

Who?

‘…this was my first exposure to a community who so thoroughly opposes doulas and midwives and natural birth…’

If you are interested, you might stick around awhile. I don’t think anyone here opposes any of those things out of hand-many of us, me included, had natural births attended by midwives. Difference was those midwives knew their scope of practice, worked closely with doctors, and actually cared about good outcomes for mums and babies, not just the process of a baby traversing a vagina.

I don’t think giving birth ‘naturally’ is anything to be proud of: a body works a particular way, so what? Lucky for us we live in a time and place where that lottery is a whole lot less serious than it used to be.

MaineJen

It’s the whole “pursuit of natural birth” that is the root of the problem, I think. You said it yourself: birth is wildly unpredictable. You cannot “plan” how you want your birth to go. You can light scented candles and take ‘tinctures’ all day long and still end up with an emergency c section. On the other hand, you can plan an induction or c section, then find yourself delivering on the side of the road with the taxi driver in attendance!

You may think you don’t want pain relief, then change your mind when transition hits. (Ask me how I know). Or you may be convinced that you’ll want the epidural as soon as you’re admitted…only to discover that you’re one of the lucky few who doesn’t really have a terribly painful labor.

The point is…women back in the day *didn’t have a choice*. 100 years ago, it was all natural for everyone. 50 years ago, it was all twilight sleep for everyone.

The problem comes in when a woman becomes hell-bent on natural birth above all else. There are midwives who will deliver breech babies at home, twins and triplets at home, don’t test women for GD, don’t test for GBS, won’t transfer to a hospital even if a woman and her family are begging for transfer. Women and babies have died in pursuit of natural birth, only to have the midwives who neglected them continue to practice without even a slap on the wrist. We’ve seen it all on this blog. If you’re getting pushback, just know that is where we’re coming from.

Anjee B.

I appreciate your comments, and I fully agree that things can change when someone is in labor, though I realize my previous comments may not have made that clear. It’s pretty tough to convey fully what one means to strangers on the internet without writing a novel to explain one thing.

What I’m not a fan of is when any provider pressures a woman to make certain decisions during labor or makes decisions for her without explaining anything, both situations I have close friends who have experienced. Those decisions may be getting an epidural or doing a c-section in a hospital with an MD, or like you mentioned, avoiding hospital transfer even when indicated during an out of hospital birth.

swbarnes2

And the pressure you think is so inexcusably unbearable is for nurses to ask a woman screaming in agony for the pain to stop if she wants pain meds?

Anjee B.

No, the pressure I am talking about is for basically any interventions that a woman wants to avoid for whatever reason. When a woman who’s not even 20 weeks has already been asked more than once if she would like to schedule a c-section when there is no medical reason to do so. When a woman nearing term is repeatedly asked if she would like to be induced. When someone has expressly stated they do NOT want a certain intervention and they are repeatedly asked about or encouraged to have that intervention. That is what I have a problem with.

Okay I did a horrible job of describing what I meant with the screaming in pain at 8 cm comment previously. For me, if I had to give birth in a hospital for some reason, and I wanted to do so naturally, I feel I should be able to request that I not repeatedly be offered an epidural. I would have gotten real rude real fast if I had someone pestering me with questions already answered while I was trying to focus on having a baby. In my opinion, me changing my mind and asking for an epidural is not the same as someone coming in my room every hour and asking me if I want an epidural now or not. I feel that hospital staff should work with and respect the decision to avoid interventions by not repeatedly asking about them – not that they shouldn’t be given if a woman changes her mind and requests them in labor. The ability to make decisions like that can be huge…

A friend labored naturally for several days and ended up exhausted; she decided, at the suggestion of the birthing center MD, to transfer to the hospital for an epidural so she could get some rest. She got an epidural, she took a nap for a few hours during which she dilated fully, then they turned off the epidural at her request and she was able to deliver her baby without the epidural. Another friend labored for days and was exhausted, and though she was very close to delivering the baby, she asked the birthing center MD to transfer her for a c-section because “I would really just like to meet my baby now.” I actually love stories like those because they remind me of how unpredictable childbirth is, and the women who experience them can say they made the call to have the intervention, even though it was something they never would have thought they would do. Hell, I begged for a foley after I gave birth because I really had to pee but I just couldn’t do it.

Sue

Since most of us here support the agency of women to choose between equivalent options, it seems strange to be complaining about people being `asked more than once` about their preferences. Situations change throughout pregnancy, people`s choices can change.

How is it a bad thing to be offered choices more than once over time?

Think about this: if you, in your first birth, assume that you won`t change your mind (about an epidural, let`s say), but clinicians who have been involved in hundreds or thousands of births might think you could change your mind, why assume that they are acting out of some sort of disrespect rather than out of competence and experience.

I`m trying not to use a derisive tone but to complain publicly about being asked repeatedly whether you would like relief for severe pain sounds like looking for issues to complain about. If it was YOU who asked repeatedly for relief from agonising pain, and were denied it, there would certainly be a serious issue.

RudyTooty

I was recently reviewing a birth plan from a patient.

In it she’d written “please offer me non-pharmacological alternatives if I ask for drugs or an epidural.”

And all I could think was “NOPE!” “nope.nope.nope.nope.nope.”

I am not playing that game.

I understand the sentiment – I do. “I want to have an unmedicated birth” [likely due to birth porn and natural birth propaganda all over the internet], but I will not override a woman’s choice. If she’s asking for an epidural (or a c-section) or whatever [within reason, within safety standards], I will make those things happen to the best of my ability.

I can’t in good conscience tell a woman that she really wants something else than what she’s asking for in the moment.

Patient: “I can’t do this. I want an epidural!”
Me: “But your birth plan says you really don’t. So let’s try some lavender oil and swinging around in this bedsheet for a while.”

No. If women ask for something – they get it.

I’ve worked with women freaking out about labor – “I can’t do this. I can’t do this. I just want a c-section.” And I’ve looked at them completely seriously and said, “Is that what you want? Because I will call in the OB/GYN and we can make that happen.”

That has stopped the panic routine for some women – when they realize that I’m not going play games with them. To me, this is respecting them. I know labor is hard and can be overwhelming (even WITH an epidural sometimes).

If I’m guessing what they want, and second-guessing what they’re telling me (like they don’t really mean what they’re saying) – then I’m not treating them like fully-functional and capable adults.

This used to be a bit of a challenge for me, because I’d been indoctrinated into believing that natural labor and birth was better – but it feels incredibly cruel and demeaning to deny women what they’re asking for. I don’t play those games.

Amazed

And I would have wondered what kind of monsters work in this hospital if they saw me in torturous pain and didn’t once tried to relieve it. To me, asking me if I’d like some pain relief shows concern and respect of my choice by giving me the chance to change it. And if I go in there with the preconceived notion that the NCB circles love to push, that epidurals are evil, impede labour and bonding, drug the baby and whatnot, I may need a “permission” by qualified personnel to admit that I want one. On the other hand, it takes exactly two seconds to say, “Fuck off” if I keep rejecting the epidural. No, mistake. Less than a second. I just checked. One second per hour is not so much.

The idea that being repeatedly offered pain relief when in severe pain is equally bad as refusing pain relief when wanted sounds ridiculous to me. In case number one, I can send the nurse off. In case number two, what am I supposed to do? Raid the hospital to find the drugs while in pain that I have already found unbearable?

swbarnes2

A friend labored naturally for several days and ended up exhausted;

Okay, so your friends(!) labored for 24 hours, and the doctor said nothing, and you approve of this. 36 hours, the doctor said nothing, and this is the care you think women should get.

48 hours, 60 hours, 72 hours…you are honestly saying that you think its agood thing that the doctor said there was absolutely nothing wrong in laboring for several days? And you think it would be best if more doctors acted just like this?

Natural birth used to kill women and babies. It’s nothing but pure vanity for any woman to think that it can’t possibly happen to her.

Who?

So you know people who were assaulted-that is, subjected to medical treatment to which they did not consent? Because that is what you are suggesting.

Anjee B.

Consent is a tricky concept when the person giving it is experiencing mental and/or physical pain or anguish. A woman in labor is pretty unlikely to say no when the “decision” is presented as “your baby will die if you don’t do this now.” And in most cases, using that reasoning is probably true and is simply a description of the risk vs. benefit, but it’s also a pretty convenient way to get a laboring women to agree to do something, which is what happened to my friend. So, yes.

Who?

So now you are saying that doctors routinely lie to patients about the status of their unborn baby to get them to have interventions they don’t need?

Anjee B.

No, I said in MOST cases docyors are probably being honest in describing the risk. Which would mean I am saying that sometimes doctors may lie or exaggerate, or that the wording they choose may be coercive.

Are you suggesting that this never happens? That my friend wasn’t coerced into an induction then a c-section? Because when I visited her in the hospital and asked what happened, her first words were “they did this to me.”

Who?

I don’t know if it ever happens, but my query is to what end would they lie about that?

Daleth

Because when I visited her in the hospital and asked what happened, her first words were “they did this to me.”

I’m wondering why you think (if I’m correctly understanding your point) that in your friend’s case, the warning that her baby was in danger was NOT what you say, and I agree, is the usual situation (i.e. not, as “in most cases, …probably true and… simply a description of the risk vs. benefit.”).

The doctor told your friend her baby was in danger, so she got an induction and then a c-section… ok, what makes you think she did not NEED an induction or a c-section? That’s what I’m not clear on.

Who?

Maybe good old ‘the baby was fine, therefore it never needed any help’ chestnut.

Amazed

The mama instinct which only works in hindsight, with the baby already safely out. Only then does the mother realize that she knows better than these pesking machines which only measure the existence of a risky situation. The mother knows for sure that her baby was never in any risk. Such a pity that this instinct only works after seeing the pink screaming baby. To some women, the only proof of interventions being needed is a half-dying baby. FFS, they even say it in their birth plans – only if in imminent danger. To them, the concept of risk is unfathomable.

swbarnes2

11 babies died and a few women Morecombe Bay under midwife care. You think that’s better? Some midwives tell clients to ignore what doctors tell them.

There was a woman here whose home birthing midwife told her it was impossible for a complication to happen so fast that she couldn’t get to the hospital in time. Are you going to stand behind that kind of honesty?

RudyTooty

I worked with one OB/GYN who offered every single patient a cesearan section. Every one. Usually in the third trimester.

Then he’d document that the patient declined an elective cesarean.

I’m guessing this was a CYA maneuver, but I did wonder how many of his patients felt pressured into a cesearan because of this discussion – few, I’d guess, because most patients still wanted to attempt a vaginal birth.

I wanted to share this, yes, some OBs seem to show a preference for ceseareans. Shrug. If I really wanted a natural birth, I would not choose that physician. Now, if I wanted an elective cesarean, I would choose that physician. He’d be perfect.

Depending on the hospital- inductions are harder to schedule without strict criteria being met – at least this is true in the area where I work and live. Other areas of the country have facilities that are more amenable to elective induction of labor. It is hard when women feel like they’ve been taken on a ride that they weren’t anticipating or asking for.

Unfortunately, this also happens with women working with midwives and in pursuit of a natural birth.

swbarnes2

But when you were screaming for the pain to stop, you wanted the doctors to ignore you, remember? You are angry that they didn’t, it’s the sole specific complain you have aired!

The Bofa on the Sofa

this was my first exposure to a community who so thoroughly opposes doulas and midwives and natural birth, and the one-sidedness of the original post set me off.

Think about what you just wrote. You, personally, have never been exposed to this perspective. And you got upset at the “one-sidedness” of this post? You just admitted that you’ve only been exposed to one side of the story your whole life! Why didn’t that set you off? Are you sure it was the one-sidedness that was the issue? Or that it was the wrong side?

But ok, now that you’ve seen it, here’s the question: do you actually understand the problems that people have? I don’t believe you do, because you misrepresent the position. I don’t know anyone here who “so thoroughly oppose doulas and midwives and natural birth.” FFS, Dr Amy, the one wrote the post, had two natural births herself! And lots of contributors here have similarly had natural births. SImilarly, there are doulas and midwives who post here. So where do you do come off with the idea that we are “so thoroughly” opposed to them?

Even I, who is probably has more problems with midwives and doulas than most here, don’t totally object to them. There are those that work properly within the scope of their responsibilities. For example, as long as doulas are there to support and assist, and avoid providing medical advice, then sure, they are great. For midwives, the direction of the ACNM has caused me great concern about CNMs, but they are at least, in principle, medically qualified, unlike CPMs, who have no basis being allowed near pregnant women, much less delivering babies.

Learn from your experience here. Get out of the echo chamber you’ve been in. You admit you’ve never been exposed to an alternate view. In contrast, we’ve heard the other side before. Like, weekly. There are good reasons for the attitudes here. Go back and read the original post, and ask, what exactly do you disagree with? If there is something you want to discuss, bring it up. Ask about it. Find out where it comes from. And then listen to the answers. I’ve learned a ton since I’ve started reading here. You can, too.

Anjee B.

“You just admitted that you’ve only been exposed to one side of the story your whole life!” – This isn’t quite true as this issue is pretty complex and there aren’t two clear “sides”, at least not from where I’m standing.

“So where do you do come off with the idea that we are “so thoroughly” opposed to them?” – From the utter lack of any positive comments about midwives or doulas from anyone other than me in this discussion. I would love to hear from some of the doulas and midwives you mentioned on this post and this issue, but I haven’t seen anything yet.

I appreciate the encouragement to stay and learn, and honestly, though I haven’t responded to every single comment or gone looking for more information or posts on this site thus far, I have spent a good chunk of this week thinking about all of this and working to process it. I gave birth less than two months ago, so I have a lot to process right now, and incorporating stories and comments here is a good thing, it’s just a lot and kind of unexpected. There’s sort of not much point in reading a bunch more if I don’t take the time to think and reflect and process, no?

The Bofa on the Sofa

“You just admitted that you’ve only been exposed to one side of the story your whole life!” – This isn’t quite true

So when you said, “this was my first exposure to a community who so thoroughly opposes doulas and midwives” you were lying?

here aren’t two clear “sides”

So when you said that the “one-sidedness” set you off, what were you talking about?

You know, we only know you from what you write. And when you write things “this was my first exposure” we interpret that to mean that you have not had any previous exposure. And when you talk about “one-sidedness” it’s about sides. But now you say that’s not what you meant?

You need to think about what you mean, and then say it. Because, as others have been pointing out, it’s what you say that is the problem.

Anjee B.

Okay. So when I first read the original post, I was given the mistaken impression that Dr. Amy was representing ALL LCs/doulas/midwives as terrible misogynists because there was no indication that she was only saying that about a select group of those practitioners. I responded to what I thought was a basic “these practitioners are good vs. these practitioners are bad” argument, which is why I said I felt the article was one-sided, and why I said I had never been exposed to a community like this before. After reading many comments and processing everything, it became apparent that the issue is way more complex than good vs. bad due to variations in practice regulations in different places. That is why I said I feel the issue is far more complex now.

I know words are important and sometimes I suck at using them well on the internet with strangers when we disagree. I hope the above clarifies where I was coming from; if it doesn’t, I’ll keep trying.

Sue

Anjee – next time you come across a longstanding blog that you have never seen before, maybe take the time to read more widely on the site before you come in with guns blazing.

It`s not compulsory to post on your first exposure.

It`s great to see, though, that reading here has given you additional insight. I expect that`s the most valuable aspect of this site.

I am a health care provider – a specialist doctor (though not an OB) – and I have learned a lot about previous assumptions by being shown the objective evidence and talking it through with people who are informed and competent.

attitude devant

“…utter lack of positive comments about midwives or doulas….” wut? Some of us ARE midwives and doulas. The blog isn’t anti-midwife, or anti-doula. It’s anti-bad-practice. And I am trying REALLY hard to think of “positive comments” about obstetricians on the blog, but am coming up blank. Because it’s not about that. It’s about attitudes and practices. It’s about supporting outcome over process, and supporting the desire of women to give birth safely with access to pain relief if they desire, and to have the information that lets them choose how to feed their babies.

Madtowngirl

There are definitely a lot of negative comments about midwives and doulas here, because so many of them practice outside of their scope and wind up harming women and babies. Many of them are so focused on ideology that they fail to properly care for their clients/patients. That’s where the negativity comes from.

Ironically, this blog has actually had me considering becoming a doula or a childbirth educator, because I would love to be a part of the push back against this “natural at all costs” ideology. There’s no reason to feel bad about needing pain relief, a C-section, or using formula, and a good midwife or doula should support a woman’s decision, rather than guilt trip her about it.

RudyTooty

I’m glad you posted – and I’m glad you hung around.

This blog is not my agreement silo – so that’s why I come here. Because I get really tired of the bias confirmation and unchallenged righteousness that occurs in “like-minded” groups.

The first time I read this blog was probably a decade ago, and I remember feeling simultaneously amused and “WTF” – it seemed over the top, and sometimes it is. IT’S A BLOG FOR PATSY’S SAKES. Controversy and offense and arguments in the comments are part of the design.

But I also remember there were commenters who were measured and rational in their commenting, and that had the biggest persuasive effect on me. In helping me see things differently- and in allowing me space to evaluate my observations and experiences with labor and birth and midwives and doctors and doulas and lactation consultants.

I just heard a radio story the other day that said the easiest emotion to convey (and monetize) on social media is moral outrage.

Azuran

Well, you did suggest Dr. Amy might be a ‘dude who hate women’ in disguise.
You say you support women to make ‘informed decision’ but then went on to complain about what kind of info they should be getting (like suggesting that negative birth stories shouldn’t be shared to avoid scaring people)
You were not taken out of context, we merely exposed to you the hypocrisy that was in your own words and you didn’t like it.

Anjee B.

The context of my comment about there being too many negative stories shared about birth was in no way meant to silence women, and I’m sorry so many here interpreted it that way.

The overall cultural narrative about birth tends to be very negative, thinking about how it is portrayed in the media, TV, movies, etc. On top of that, when a woman is pregnant, she is bombarded with horror stories, starting with pregnancy through the postpartum period. It’s not that women’s stories shouldn’t be told, it just really bothers me that so often women share negative comments, unsolicited. The state of being pregnant is not an invitation for any woman to say something like “oh good luck, I tore all the way to my butthole and couldn’t sit for 8 weeks” or “you better just hope the baby isn’t really colicky.” After my husband and I explained that we were planning/hoping for a natural birth, his sister’s only comment was “you’re gonna want an epidural.”

It’s just super shitty that this is how so many women relate to each other and the experience of pregnancy and childbirth. For the women who want to relate that way, that’s your choice, but as women, I don’t think we should assume that every pregnant woman wants to hear your experience. Unsolicited “advice” or sharing, especially in face-to-face conversation isn’t cool with me.

Regardless of how much any of us liked or didn’t like being pregnant and going through labor and how easy or hard we perceived any step of the process, every single mother did a freaking amazing thing by growing a tiny human, giving birth to them, and then keeping them alive when they are so tiny and needy! There’s so little celebration of the positive, of the fact that we are all badasses for making a person. That’s what upsets me and that’s the context in which I meant I’m tired of the negative narratives about childbirth – not individual women’s stories, but the isolated comments and the overall lack of respect and awe of the process by society at large, especially among women who experienced these things.

I’m a pretty staunch agnostic, but the experience of pregnancy and childbirth and now having a six-week old has been the only thing I would ever consider calling a miracle. It’s really special, it’s really awesome that we as women can do this, and I wish that reminding each other of that was at least as normal as telling each other what went wrong for us.

The Bofa on the Sofa

The overall cultural narrative about birth tends to be very negative,

3000 years ago, childbirth was recognized to be so painful that it was considered to be punishment from God.

You know how women live longer than men? That has not always been the case. Historically, women had shorter lifespans, on average, because of death during childbirth.

The negative aspects about birth are not made up. The reason the narrative about it tends to be negative is because it commonly has been a negative experience. That just is a fact, and no amount of unicorns and wishful thinking change it.

Anjee B.

I’m aware childbirth has never been a picnic. I guess I just don’t quite understand if there are all these interventions now to minimize the danger to woman and baby and to optimize the comfort or convenience of the experience for the woman – why isn’t the experience overall becoming more positive for a good number of us? Or is it, but we don’t know how to talk about it in that light? I don’t have the answers to those I’m just wondering.

MWguest

“…why isn’t the experience overall becoming more positive for a good number of us? “

I can see what you’re saying – because there is a lot of complaining/ commiserating around pregnancy and birth.

If we take a long view, hundreds of years or more, we can confidently say that more women and babies are surviving pregnancy and birth, so yes, it IS getting better. Surviving is a positive thing, in my mind.

Who?

The interventions were always about making pregnancy and birth safer-my impression is that the idea that birth is an experience, to be curated, is more about marketing than medical care.

No one being dead or permanently injured is now the baseline, which is a huge move from even 50 years ago. With that baseline in place, perhaps the previously unimaginable opportunity to curate the experience has become the new normal.

The idiocy of ads for baby stuff featuring smiling, trim, elegant, well-rested parents in an immaculate home with a cuddly bundle of sleeping joy in its perfect nursery has become the standard. Pretty much no one meets that, hence disappointment.

Sue

`why isn’t the experience overall becoming more positive for a good number of us?`

This is common to all areas of health – it relates to the increasing expectations that come from spectrum bias.

The more our health outcomes improve, the more we worry about less disastrous issues. Now that we see so few women and children die in childbirth, we are able to focus on less dramatic issues. Now that few children die of vaccine-preventable diseases, we can focus on minimising the risks of vaccination.

When our basic needs for food and shelter are met, we focus on other areas, and our risk tolerance falls. This is human nature.

We now have better and faster communication methods than ever dreamed of in the past – and yet people still complain about their phones and internet speeds.

That does not mean that we aren`t objectively better off – it means that our expectations are higher.

space_upstairs

I don’t think negativity in itself is the problem. In those historical times that Bofa talks about, childbirth was seen as the mortal risk that it honestly was back then and still can be now without, well, the option of high-tech medical intervention, and that was that…people still had kids and such.

I think negativity becomes so daunting when it’s a reaction to unrealistic expectations and desires stoked by our hyper-capitalist society and, unfortunately, sometimes by its strong preference to promote positivity in sales pitches. People would probably not complain as much about pregnancy and childbirth circumstances if they had a realistic set of expectations about it. They complain about early parenthood and parenthood in general because they were hoping or expecting at first maybe not to have colicky babies and maybe not to have complications in childbirth, because they were taught that there’s nothing more wonderful and worthwhile to do than parenting but also that they were supposed to be able to do whatever they wanted easily, and have confidence in wealth and prosperity for the family’s next generation, and have a love like no other in their life, and…a lot of things that probably never matched the reality for the average parent.

I’m glad to have been hearing all these negative stories because it helps me calibrate my expectations and plan for issues as I go along, and be glad when things turn out only slightly or briefly unpleasant rather than disappointed they didn’t turn out propaganda-perfect. Occasional bouts of urinary retention are more tolerable when I know I could have had a miscarriage, one day of barfing seemed like no big deal after having heard about hyperemesis gravidarum, cravings are a breeze when they’re not for something extremely rare and hard to get or something that’s not even food (pica), and a few clumsy moments or rough mornings are no problem when I supposedly could have started to experience “baby brain” by now.

Anjee B.

“People would probably not complain as much about pregnancy and childbirth circumstances if they had a realistic set of expectations about it.”

That’s probably true. I am a person who reads all of the things to find out what to expect with new experiences, which is why I don’t want to hear a comment from every woman I encounter who has been pregnant, though I did certainly still ask for stories from some women. I know other people tend to learn from conversations and stories, so it would make sense that some women might want to hear the negative stories. The story tellers should perhaps try to respect that not everyone wants to be on the receiving end of their comments?

momofone

Or the people on the receiving end should be adult and assertive enough to say they don’t want to hear it. I was quick to stop people–“Oh gosh, thanks, but I’ve decided not to hear the war stories.” If that didn’t work, I walked away.

Who?

I think that’s right-far too often war stories are actually free therapy for the speaker. No need to sign up for that, unless for some reason you want to.

Also important to remember when hearing war stories (on any subject) that there are multiple perspectives-the speaker may have a wound to heal, an axe to grind or a decision or action to justify.

Azuran

Those are just normal part of normal conversation. If you tell people you bought a puppy, people will tell you about their own dogs. If you tell people you are buying a house, they will tell you about them buying their own houses. if you tell people you are pregnant, they will talk about their pregnancy. That’s just how conversation works. At any time that you do not want to talk about something, just say so and move the conversation elsewhere. Dont extend your experience tho the whole world.

I personally happen to think that we don’t talk enough about the negative side of pregnancy and birth. I was like 7 and I already ‘knew’ that I would have a natural birth without an epidural because that’s the ‘normal’ ‘woman’ ‘natural’ thing to do. Because having an epidural was always talked about as if it was a failure. And everyone was like ‘once you see the baby, you forget all the pain’. Having a c-section was like, the worst thing that could possibly happen, people gave condolences to women in my family who had them.
Sure, being able to create a life is awesome. But the process is still full of various pains, morning sickness, discomfort, disappointment and even sometime death. And this shouldn’t be hidden.

And really, there is a LOT of celebration of the positive. People everywhere are posting endless pictures of their bellies, their US pictures, their births and babies online, we do baby shower, we give gifts, I have like 5000 pictures of my baby, Go anywhere outside with your baby and at least 10 people will congratulate you for it.

MaineJen

Pro tip: you do NOT forget the pain. :/

Heidi

No, I would never say that childbirth is a miracle or remind other women how awesome it is we “can do this.” Because some women can’t, and how insensitive is that? What about women who don’t want children? That’d be like bragging about my blood sugar being good after eating a donut to a diabetic. It’s a thing our body does that sometimes works out for us, but a lot of times doesn’t. Actually implying it’s a miracle implies that most the time it doesn’t turn out okay, which seems to contradict what you believe.

I also recall you implying women are too scared about childbirth now. Why do you think that? If it was made out to be that scary, I think women would be running to the streets demanding permanent sterilization. But that’s not the case. A lot of women are still having children, while having a healthy, rational fear of childbirth! Most of us, I bet, are comforted by the fact we can choose to give birth in a hospital setting where adequate staff can rush us to an emergency C-section if needed, can intubate our baby if s/he comes out not breathing, we can be given blood products if we hemorrhage, easy access to an IV is already there so time won’t be wasted, and an epidural already being place is nice if we do end up needing a C-section. Don’t you find it a bit hypocritical to make these claims about fear when you were trying to stoke fears about epidurals?

Charybdis

There’s the flip side to that coin as well: women who want to have pharmaceutical pain relief (epidural, stadol, demerol, or other opiate), want to have an elective CS, prefer to have an OB in charge of their prenatal/delivery/postnatal care, opt for induction anytime after 38 weeks, have no problem doing the GD glucola test, plan to deliver in the hospital and plan to use formula to feed their baby. Those of us who are opting for these things are bombarded and browbeaten about “a cascade of interventions”, how a midwife is a much better choice for care, using a tub for labor, questioned as to whether we are considering a home birth and how much BETTER they are, and of course, the ubiquitous skin-to-skin, “golden hour” and BREASTFEEDING and rooming-in nonsense that is being foisted off as “best policy”.

The constant yammering about “of course you will be breastfeeding, breast is best, bonding, your body was MADE TO DO THIS and women have been having babies naturally (vaginally) since forever is getting pretty damn old. Women are constantly “reminded” of the so-called dangers of formula, horrible OB’s who are only worried about getting home in time for dinner or their golf game, that a hospital labor and delivery will be “on the clock” and they will strap you down to the bed, shave all your body hair off whilst giving you an enema so that you can deliver “on schedule” before the shift changes.

As soon as you announce that you are pregnant, the NCB rhetoric starts coming at you hard and heavy. Breastfeeding, rooming in, midwife, out of hospital birth, water birth, no pain relief, vaginal delivery, declining GD testing, etc. And when you mention that you don’t want those things, then the “education and support” stuff starts, especially with the VBAC/HBAC folks if this is a second/third pregnancy.

Amazed

Context: a screaming woman at 8 cm. She says she’s in pain. She is yelling for epidural. Anjee B. claims that this should not be taken into account, that only the wish she expressed before she experienced labour – first time labour OR this particular labour – should be valid.

Anjee B. gets insulted but she STILL has no time to reply to the many posters who pointed out the hypocrisy of this particular “let’s respect each woman’s choice” defender. She insists that she supports every choice of every kind of birth but STILL has no time to reply why does she only support a choice made in ignorance and won’t let a woman change her mind if she chooses something Anjee B. doesn’t think right.

What other context?

Oh, and you can stop pretending that this was your first encounter with such one-sided view. I saw your name at Dr Amy’s Facebook page. You’ve had many days to expand your knowledge of what we stand for, yet you repeat the same things you wrote at her page.

This is the context your words should be taken in.

Anjee B.

I guess I should apologize to you for not sitting in front of my computer 24/7 to reply to every single person who commented, no matter how rude or trivial their comments? And for not spending every second between responding to comments working to expand my knowledge of what you think? Nah, I have a baby and also a life. I will respond to any specific questions you have for me at this point, but I’m not going to go back through 100+ comments to try to figure out which ones you wanted me to respond to.

If you looked at the timestamps on here and Facebook, you might notice my original comments in both places were made around the same time, so yes, actually this is my first encounter with this scenario. I only came across this because of an advertisement on Facebook, so if you don’t want people coming here from there, perhaps you should ask Dr. Amy to stop running Facebook ads.

Amazed

Oh, I wouldn’t lay any claims on your time. I simply noted that person after person told you about this specific problem with your line of thinking – and they did it quite politely, so the rude and trivial defense won’t hold. The posts like mine were the minority. But you still won’t answer, although I, personally, have made you repeatedly aware of what one may presume reading your posts. Still, your time, your choice. I am just making a note, in case someone decides that you are being honest in your defense of choice rhethorics.

I don’t mind people coming from Facebook. What made you think so? I am just stating that you wrote the exact same post in a few days interval. This isn’t “about the same time” when we’re talking about reading a few posts. I just dislike when people pretend they’re shocked and stunned by what Dr Amy writes when they have seen it before. She isn’t into changing her style of posting.

Daleth

I have never personally felt pressured to have a natural birth for any
reason, as the original post discusses, so it was a new idea to me that
women would feel this way

I’m glad you weren’t pressured. I was, and I don’t mean I felt pressured. I mean I actually was pressured by my medical team, over and over, for months, to attempt a vaginal birth. I originally had planned to go that route–in fact, I signed up to deliver with the hospital midwives, but they risked me out when an 8-week ultrasound showed I was expecting mono-di twins (i.e. identical twins who share a placenta). I mention the midwife plan that to show I didn’t walk in the door biased in favor of “interventions” or inductions or c-sections, at all.

So, they risked me out and not even just to an OB-gyn, but straight to MFM (a team of maternal-fetal medicine specialists), because mono-di is very high risk (in addition to the usual extra risks of twins, about one in eight mono-di pregnancies develops a condition called twin-to-twin transfusion syndrome, which is always fatal to the babies if not caught and treated in time).

And on top of that I was a first-time mom aged over 40. And on top of that, mono-di pregnancy is very hard on the placenta, so it tends to fail early, and as a result, if you let a mono-di pregnancy reach week 38, the stillbirth risk skyrockets to ONE IN FIFTY. The optimal time to deliver them is in weeks 36-37; that’s when they’re very distinctly safer out than in.

So I read up on mono-di pregnancies, finding and reading studies on PubMed, and learned about the risks, and read up on c-sections and inductions and epidurals, and decided pretty early on–maybe by week 12 or 14?–that I wanted an elective c-section. Even fraternal twins (the lowest-risk kind) are all by themselves a medical indication for a c-section. Mono-di twins? Definitely.

I mean, even if you do attempt a vaginal birth with mono-di twins, you have to do so in an operating room because there’s a fairly high risk that Twin #1 will pull the placenta off the uterine wall during delivery, leaving Twin #2 inside with no oxygen, which requires an immediate c-section. About half of mono-di moms who attempt a vaginal birth end up with either an emergency c-section or BOTH: Twin #1 vaginally, then #2 by c-section, so you have BOTH types of childbirth to recover from!

So I was like, “You know what, I don’t want to run that risk; let’s just schedule a c-section.” But even though I had mono-di twins AND one of them was either breech or transverse at every ultrasound but one, I still spent MONTHS having my doctors decline to schedule an elective c-section, constantly ask me if I was really sure about wanting the c-section, reassure me that they just had a patient “even smaller than you” deliver triplets vaginally without a problem, blah blah blah, and so forth.

I came in with a half-inch stack of printed-out study abstracts, absolutely all of which weighed in favor of my decision, and the MFM still tried to scare me into going for a vaginal birth because, as he put it, “There are some risks to c-section that you don’t get with a vaginal birth. For example, the scalpel can slip and cut the baby.” This was a surgeon who routinely performed life-saving surgeries on second-trimester fetuses, and he was trying to make me think he’d do an oopsie with the scalpel during a routine c-section?! It was pure scare tactics.

Three days before I delivered, the head of MFM tried yet again to convince me to attempt a vaginal birth. All this BS about demonizing c-sections has made hospitals work very, very hard to bring their c-section rate down. It’s insane. Their attitude was, “Sure, there might be an emergency, but we’ll be able to handle it.” Which I’m sure they would’ve been–it was a major university maternity hospital. But my attitude was, “I don’t want to take the risk of an emergency; I don’t want to end up needing an emergency CS in the middle of the night with an exhausted medical team; I don’t want to spend any time scared to death and praying that you’ll save my babies. I just want a nice, planned c-section.”

I guess my point is, women don’t just FEEL pressured. We actually are pressured. You didn’t feel the pressure because you didn’t ask for a c-section.

Anjee B.

Thank you for sharing your story. It sounds pretty ridiculous that they would be trying so hard to minimize c-sections in high risk patients, but I don’t doubt that this happens more frequently than anyone wants to believe. I’m sorry you had that experience pressure in that way. I didn’t mean to imply that the pressure women feel is not really there when I said “feel pressured,” as I’m sure there’s a broad spectrum of how this manifests.

Healthcare and medicine are pretty broken right now, for so, so many reasons; misdirected goal-targeting like you described is just one more example of this for me. When I’ve said doctors don’t always focus on patients as people or patient care as priorities, this was a broad statement, and I wasn’t just talking about Ob/gyns (or doctors for that matter – let’s talk about prescriptions per hour for my colleagues in retail pharmacy, assessments for nurses in hospitals, documentation requirements everywhere, etc.), it is a much bigger issue that is primarily a result of the systems in place, especially with respect to payment and efficiency expectations. Anyways, I digress, just trying to give a bit of insight into how much more complex I feel some of these issues are than can easily be described and discussed as isolated concerns or problems.

Who?

Perhaps it’s just me, but you don’t seem to have much respect for the professionalism of doctors: here, you are surprised they fail to book a cs for a high risk patient, but ‘don’t doubt it happens more freqently than anyone wants to believe’.

Down below you assert that doctors lie to their patients about an unborn baby’s health, to make the patient consent to what you understand to be unnecessary interventions.

Which is it-under-acting danger freaks or over-treating monsters?

Platos_Redhaired_Stepchild

Breast pumps aren’t any more natural than formula. Yet most “lactation experts” insist every mother needs one to breastfeed as nature intended.

RudyTooty

Hallmark of misogyny.

I love this.

Who?

So you’re not trying to put down women (not parents, women) who choose formula for their children, you just struggle to imagine how feeding with a substance that has sustained millions of children for decades is ideal.

Nice. Interesting to know what you would say if you did want to put them down!

MaineJen

“Misguided” feminism. K

Sarah

You say that like you think your struggle to understand is somehow relevant.

Heidi

If you are a lactose intolerant baby, and this does occur, of course corn syrup solids are better than lactose! Where do you all get this crap from? Lactose-free formulas have to use SOMETHING to replace the sugar that can’t be lactose. Default formula does not contain corn syrup solids.

The Bofa on the Sofa

And so what if they did? The long term outcomes of formula use are known, and they are not a problem. So why should we have concerns about “corn syrup solids” in formula, even if they were there?

But…but….formulas contain simple sugars that are refined from corn syrup solids! The vile nature of the production by a plant is forever stamped on the molecules themselves!

How often do you think Anjee puts together compounded IV fluids that contain highly refined sugars isolated from corn syrup or sugar beets as a pharmacist at a trauma ward? Hourly? Every 15 minutes?

Sarah

I bet she uses breastmilk instead.

Heidi

I kinda laughed at this myself. I used to culture dairy milk with kefir grains but decided to switch over to soymilk. I didn’t want my grains to die so I was trying to figure out a dairy-free way to feed them the right sugar. So I discover lactose is mostly glucose with a wee bit of galactose. Evidently galactose isn’t unique to animal milk but can be found in plants, like figs. Anyway, I bought a big bag of dextrose, which is derived from corn but it’s still glucose. And glucose is glucose; it’s still the same molecule! I add a tiny pinch of galactose. I didn’t get super scientific about it as I don’t even own a scale that could measure that small, and I know it’s not lactose I made but it seems to keep my grains happy and fed. Just like corn sugar keeps babies happy and fed!

Box of Salt

Actually, lactose is one glucose molecule bound to one galactose molecule – so that makes it 50% galactose, not a “wee bit”. Of course, galactose itself is just an isomer of glucose – almost the exact same molecule, but with one hydroxy group pointing the opposite way.

Heidi

I took Chemistry in Our Community in high school. Never been my thing. I thought I had read lactose had a really small percentage of galactose but me wading through the “research” was about like an anti-vaxxer reading through scientific studies, except I only have kefir grains to kill.

Daleth

I’m aware of the history of twilight births involving misguided “feminism”

Why do you say they were “misguided”? You’re seriously telling a bunch of women 100 years ago that you know better than they did what was best for them? Don’t you see that that’s incredibly patronizing?

The Bofa on the Sofa

Yeah, when Queen Anne (or whichever queen that was) insisted on chloroform as anesthesia for her delivery, was that a good thing, or “misguided”?

All of Anjee’s arguments are incredibly patronizing – and ragingly hypocritical from a pharmacist.

Daleth

I struggle to imagine how feeding infants with a substance made mostly out of corn syrup solids is ideal

I struggle to imagine how feeding infants with bodily fluids that are full of pus and blood and environmental pollutants is ideal… OH WAIT… breast milk is NOT full of pus and blood and environmental pollutants! Ok, now that I’m looking at facts instead of incorrect beliefs, it’s much easier for me to imagine how breast milk could be a good thing.

Similarly, formula is not “made mostly out of corn syrup solids.” Like breastmilk, it’s mostly made of lactose (milk) and fats, plus DHA, lutein, various vitamins, and iron. It’s available in organic and non-organic versions–whatever mom wants. Now can you imagine how it might be good?

My point is that if you have bad information, you’re going to have incorrect beliefs. It happens to all of us–on different topics for different people, of course.

other than in situations where breastfeeding is not feasible. This is
including a mother not being interested in breastfeeding as a scenario
where breastfeeding is not feasible, I’m not trying to put down women
who choose formula.

I actually really appreciate your saying that a scenario where mom doesn’t want to breastfeed is something we should respect. A lot of “natural birth/breast is best” types don’t respect women’s autonomy: they genuinely believe that it’s a good thing to try and shame women into an unmedicated vaginal birth, exclusive breastfeeding, etc.

I also notice you didn’t respond to any of the other examples of
historical or current day misogyny within standard obstetrics practice

I don’t have all day to respond to internet chatroom posts. If you want an answer, here we go–you mentioned “Strapping women down during labor? Telling women they have to lay on their backs on a table in what is a counterproductive and highly uncomfortable way to labor? Refusing them food and water but insisting insisting on an IV line and continuous (sometimes invasive) monitoring?”

Strapping down— sure, bad, but also not done anymore.

Lying on back–the evidence is mixed on whether laboring in that position is counterproductive or not. Laboring in a sitting or standing position can increase the risk of third and fourth-degree tears due to the extra pressure it places on the perineum.

Refusing food and water — if you’re a pharmacist you must understand the logic here: easily 20+% of labors end in an emergency c-section, and if mom didn’t have an epidural placed, she will probably need general anesthesia (if she had an epi then they can usually just increase the dose and operate without knocking her out). And what do ALL surgery patients, male and female, get told? Nil by mouth for 6-8 hours before surgery, in order to ensure there’s no risk of choking to death on one’s own vomit in the OR.

Do you really think it’s misogynistic to tell women “since there’s a 20-25% chance you’ll be having emergency surgery today, don’t eat and drink until after the risk of surgery is past” (i.e. after birth)? Personally I think they should let women have spoonfuls of honey or sugar or jelly or something, to give energy with essentially zero increased risk of choking, but I don’t see how overzealous anti-choking measures are misogynistic.

insisting insisting on an IV line Are you referring to heplocks? IOW, not actually an IV line, but an IV port in case an IV line is needed? A heplock saved my life and ensured I didn’t need blood transfusions. That’s why doctors recommend them (they don’t “insist”–if you refuse, they don’t put one in anyway–but they strongly recommend them). The point of a heplock is that hemorrhage can make your veins collapse, making it difficult or even impossible to get an IV line in when you need it. If you already have a heplock, that risk is eliminated.

Because I had a heplock, when I started bleeding to death and going into hypovolemic shock, they popped a saline IV onto the heplock, reinflating my veins and preventing cardiac arrest. If I hadn’t had a heplock, that process would have taken longer, so worst case I might have gone into cardiac arrest and died; best case, I would’ve lost even more blood and required transfusions. Is it misogynistic to strongly recommend that women have an IV port in case it’s needed to save their lives?

insisting insisting on … continuous (sometimes invasive) monitoring

Is it invasive to have a cloth belt around your belly that records your baby’s heartbeat? I can see how it would feel invasive to have one of those monitors that they attach to the baby’s scalp while it’s still in the vaginal canal, but those are rare. For most women, the belly belt is used. And again, it’s used so that they can see whether the baby is in distress. How is that misogynistic?

The day before my son was born, I had a single IV placed for magnesium sulfate and Ringer’s in my left hand. HELLP syndrome had somehow made getting venous access a drawn-out horrific process instead of the super-easy process I was used to.

My nurse asked how I felt about getting a hep-lock on my right hand. I smiled and said that I would greatly prefer a hep-lock placed in my right hand than the experience of having someone trying to place a central line in my neck while running beside my gurney if I crashed. She flinched ever so slightly and said “yeah, that’s not fun for the nurses either.”

That’s when I remembered I was in the high risk L&D again…..

She brought in the best nurse for placing IVs. The first try was terrible because she was trying to get it right next to a bone in my thumb and it was all I could do to lay still, breathe, and not scream..probably a 7/10. Before placing the second one, she said that my best access point was in a vein that had been blown before – but she was pretty sure she could hit it. I asked if she had anything to numb that area before she went to work. She gave me a dose of local lidocaine. I had a tiny bit of pain – maybe 1/10 – that was totally manageable.

I had “Righty” in until I was off magnesium sulfate 24 hours after Spawn was born. “Old Lefty” stuck around in one form or another until was getting ready to leave. In fact, since I’m a lefty, “Old Lefty” is in a a lot of pictures from Spawn’s first week.

Gæst

I think it’s a little misogynistic that they are so itchy. How hard is it to make a belt that’s comfortable and does what it needs to?

Daleth

How hard is it to make a belt that’s comfortable and does what it needs to?

I think the itchiness is because they use velcro, which is the only way I can think of to make one belt fit women of all sizes.

Gæst

It was more than that for me – it itched all over. And I think Velcro can be used in a way that’s not itchy.

Daleth

My guess is it itched all over because it was velcro all over. The ones in my hospital were just long velcro straps with some buckles or clips or whatever here and there.

Anjee B.

This is the worst piece of writing I have read about anything childbirth-related since I became pregnant last fall. Are you sure you aren’t a dude who hates women? Women should be uplifting each other and supporting WHATEVER informed decisions they make about pregnancy and chidbirth. Your perspective is damaging and useless because you have a very, very clear agenda that is not to support women but to support medical intervention and insult any women who do not agree or who want to experience childbirth naturally.

You write “They do so by tying the lifesaving technology of modern medicine — epidurals, C-sections and infant formula — to “unnatural” women.”
Please provide some evidence-based medicine that supports how beneficial epidurals, c-sections, and infant formula are compared to lower intervention births and breastfeeding? These things are life-saving WHEN NEEDED. I’m pretty sure you are supporting a misogynist agenda by insisting that these things are so fantastic when they only exist in their current form for the convenicence of Ob/Gyns, hospitals, and the capitalist system these things are built upon. Why not mention all the benefits of episiotomies while you are at it?

You write “It’s a very bad idea to criticize the people on whom you depend for employment.”
Isn’t that what you are doing here? Isn’t the whole point of feminism that women should have autonomy and control? You are telling them what to think and what is best (which you seem to think is as much medical intervention possible), rather than providing balanced information and letting them choose. Pregnancy and childbirth are not diseases, they are natural processes, and there is absolutely nothing wrong with encouraging those who are interested in natural childbirth to pursue it. If it didn’t work, we wouldn’t have survived as a species. It also isn’t for everyone, which is fine.

You write “That backlash comes as women recognize that midwives and doulas aren’t leading them to heaven, but rather to a hell of excruciating labor pain, frustrating breastfeeding attempts that harm their babies, and being relegated back into the home.”
Wow, just. Wow. “Frustrating breastfeeding attempts that harm their babies” – again please provide some context here because I believe all evidence out there suggests that breastfeeding has better outcomes than formula. And “a hell of excruciating labor pain” – fearmongering much? That’s a terrible thing to say because it sets up ALL women, including the ones you like who want all the medical things, to be absolutely terrified of something that is a natural process. Yes, natural childbirth is intense/painful, but it is not always unbearable or again, or we would not have survived as a species.

What utter garbage. The history of obstetrics is one of misogyny, and you don’t even seem willing to acknowledge that. Twilight births? Strapping women down during labor? Telling women they have to lay on their backs on a table in what is a counterproductive and highly uncomfortable way to labor? Refusing them food and water but insisting on an IV line and continuous (sometimes invasive) monitoring? Presenting things as “now we are doing this” rather than giving the woman a choice? These things all sound an awful lot more like an entire profession who do not respect women, things grown out of misogyny. To say that the current state of high-intervention birth in the United States represents feminism is ridiculous. It doesn’t matter if many Ob/Gyns are women if the training they receive is rooted in this history of misogyny, the women doctors can learn misogyny just as surely as black cops can learn racism when they join the police force.

Daleth

The history of obstetrics is one of misogyny, and you don’t even seem willing to acknowledge that. Twilight births?

Twilight births were hailed by feminists at the time as a revolutionary improvement. American feminists held public demonstrations to demand that doctors allow them the option of twilight births, and articles in women’s magazines advocated for women to have the right to choose that way of giving birth. Google “twilight birth feminist” and you’ll find tons of articles about that.

I believe all evidence out there suggests that breastfeeding has better outcomes than formula

Nope, the evidence out there is mixed, and all of the studies that show better outcomes for breastfeeding are plagued by the same fundamental flaw: the study design is never a randomized trial (i.e. women are randomly put into the breastfeeding or formula group, those groups are demographically matched to each other, and then you compare how the babies do).

Instead, women just choose which way to feed their baby–so you get groups that are not demographically matched at all: the women who chose breastfeeding are disproportionately wealthier women with good maternity leave and/or high-earning husbands who can support them as stay-at-home moms, while the women who choose formula are disproportionately the ones with bad or no maternity leave, no husbands or ones who can’t support them, etc. In other words you’re comparing middle-class and rich women to poor women. We already know that poor people are less healthy than wealthier people, do worse in school, etc. That was true back in the 1950s-80s when almost everyone (rich or poor) was raised on formula, and it’s still true today.

A few years ago, Ohio State University did one of the very, very few WELL DESIGNED breastfeeding studies: to make sure they weren’t just comparing rich babies to poor ones, their study compared breastfed kids to their own siblings who had been formula-fed. Result? No differences–except that it turned out breastfed kids were slightly MORE likely to get asthma:

Epidurals allow women to not feel mind-erasing pain? How is that something that warrants a “WHEN NEEDED” warning? Do people do that with any other form of anesthesia? A family member of mine (male) just was hospitalized briefly and needed to stay pretty still to be monitored safely, no one says that was “capitalist” and “emasculating” – why is it only women’s advances that are troublingly “corporate”?

Anjee B.

Epidurals also have side effects and potentially fatal complications because they involve inserting something into a woman’s spine which is not the typical route of administration for most other pain medications and conditions. And yes, pain medications are FREQUENTLY ordered “WHEN NEEDED” for a wide variety of patients and situations, even in the hospital setting – I work at a level 1 trauma center as a pharmacist.

Pain medications should really only be used when needed or when desired, which is not all the time. Childbirth is a natural process that healthy women and babies experience, and thus has no easy comparison in the medical world to other pain conditions which are caused by diseases and illness. The expectation of patients in any setting that they should have a pain level of 0/10 when faced with painful situations is unrealistic and is part of what has driven the opiate epidemic in this country, though that is a whole other topic.

My issue is that the focus is not really on taking care of women with childbirth, it is on the convenience of doctors and hospitals. Why are so many babies born Monday thru Friday if this is not the case? The NICU, while an amazing, life-saving resources for babies who need it, is also a money-making center in labor/delivery hospitals… It’s not just a women’s issue, healthcare as a whole in the United States is broken because corporations and capitalism are not capable of caring for sick people. The pharmaceutical industry, don’t even get me started there.

Allowing them to suffer hideous pain because epidurals rarely have serious side effects, although they are generally quite safe for mom and baby? That’s cruel.

Not scheduling inductions and cesareans? Because that’s the only way I can think of to avoid M-F births. Do that, and you’d best prepare for a heck of a lot more peripartum deaths and serious morbidity, since Nature frequently sucks at scheduling labor and delivery.

Not sending sick babies to the NICU? Okay, what kind of sicko are you, advocating that fragile newborns who can die a few hours after showing just subtle symptoms should just be left to do he best they can?

Do you not support Rhogam for sensitized mothers, or Vitamin K shots, or antibiotics for Group B strep? Those interventions have unequivocally saved many lives–including mine. (O-negative mom with previous O-positive pregnancies.)

This country has lots of problems with its medical care–namely, that some populations don’t get the preventive care they need, or who raise a concern only to have it dismissed. Iatrogenic injury from interventions absolutely pales in comparison to these causes of death and injury. Childbirth is and always has been risky, which is why obstetrics have saved so

The Bofa on the Sofa

Allowing them to suffer hideous pain because epidurals rarely have serious side effects, although they are generally quite safe for mom and baby?

Right. I should have said “forcing,” since Anjee wants to remove women’s choice to have an epidural.

Heidi

I just love how she suggested that medical staff should ignore a woman when she demands an epidural when 8 cm dilated and is in excruciating pain! How empowering it is to be told you “aren’t in the right state of mind” and told your current requests aren’t valid. Wait, no, it’s quite the opposite of that.

I asked for an epidural when I was about that far along, only because I dilated much faster than expected, and my medical staff really cared about getting it to work, which was no easy feat given how quickly I went. Don’t regret getting it for a second! Yes, I got to experience a lot of pain, but I really, really don’t want to know what getting ripped a new one and then getting stitches felt like.

Anjee B.

If a laboring woman doesn’t want an epidural, she should not be repeatedly asked during labor when she is not in an appropriate mental state to answer that question and has already indicated repeatedly prior to labor that she does not want that intervention.

Also can we consider that some of us believe that childbirth is a beautiful experience, and that the pain and intensity of feelings that occur are not “hideous”? Did I yell a lot at points and mumble something about wanting it to stop? Yes, I did. I also had an amazing support team with me who helped minimize the pain and encourage me to do what I set out to do, which resulted in me having a freaking amazing natural childbirth experience. It is not for everyone, but if I had given birth in a hospital rather than a birthing center, even with my same MD, it would have been a constant struggle to have my experience reflect anything close to what I actually wanted.

Optimal care for laboring women should center the care on the woman. Not on what she’s screaming when she’s 8 cm, but on what she wants overall and has prepared and planned for, within reason as events unfold. Rushing to a c-section so the MD can get home for dinner or inducing so the MD can get the birth in and leave for the weekend… those things are NOT okay, and they happen all the time. That’s not caring for the woman as a person.

Scheduled inductions and c-sections are fine, so long as the woman is not being coerced into them with fear-mongering garbage which really again translates to the convenience for the MD’s schedule or to minimize the MD’s liability because they don’t feel comfortable with this or that.

I’m not sure why the timing of labor and delivery by nature should contribute to morbidity and mortality? Maybe doctors and hospital should realize that births can happen at any time and schedule/staff appropriately?

You entirely missed my point about the NICU. Sick babies should go there. Babies who are not sick should not go there to meet the hospital’s quota for the week or month. Also, if the baby is in the hospital already and something starts going badly, they can get to the NICU pretty darn quickly; I thought this was the argument for why babies and mothers need to stay in the hospital for several days after birth, to monitor things even if they seem okay.

Asking me about Rhogam, etc. is silly. I support life-saving therapies, yes. I do not support medications and interventions for the convenience of the doctor or hospital. I’m not sure how that is unclear.

Iatrogenic injury from interventions? How about the fact that women will always remember how they were treated during labor and childbirth? What about the emotional and mental health implications of interventions that women did not want but were coerced into getting? Again, I am simply saying we should focus on caring for women, for each individual woman.

momofone

In general I find childbirth pretty squicky, but my child’s birth was beautiful, made more so for me by the fact that I was not in agonizing pain when it occurred.

Heidi

What a bunch of unsubstantiated bullshit. Are you trying to meet a word quota?

The Bofa on the Sofa

If a laboring woman doesn’t want an epidural, she should not be repeatedly asked during labor when she is not in an appropriate mental state to answer that question and has already indicated repeatedly prior to labor that she does not want that intervention.

Of course, then, what do you do about those women who have previously stated that they don’t want an epidural but then change their mind?

Here’s the reality of it: the reason the nurses keep asking laboring women if they would like to have an epidural, even though they have previously said no or even never, is because, in their experience, women who have said no or even never can and do change their mind. They are more concerned about making sure that women who want an epidural get one than about hurting the feelings of someone who has said no.

BTW, one of the reasons that the woman is “not in a mental state” where she can refuse is because she is in too much pain. In fact, that is the PERFECT time to be asking her if she wants an epidural.

Mari

I would much rather be repeatedly hassled about an epidural I could turn down than be denied one when in excruciating pain. The power imbalance of the situation means that offering (even if causing minor irritation) will always be more ethical than withholding.

guest

I have had both experiences – being repeatedly asked if I wanted an epidural when I had said I didn’t want one and being refused an epidural when I kept asking over and over (2 different labors). Hands down, the labor that was more traumatic for me was the one where I was denied an epidural. Being asked repeatedly if I wanted an epidural barely registered in my brain, but 4 years later I vividly remember the pain of the labor where I was denied.

sdsures

Withholding pain relief when it is requested is abusive.

LaMont

“Fearmongering garbage” – tell that to my friend who lost her twins after a pregnancy complication. Or my friends who have had multiple miscarriages. Or my friends whose infants have been in the NICU after birth injuries. Monstrous – to deny women real facts because only a light-and-rainbows view is allowed.

Your statement that you wanted the pain of labor to end – but were surrounded by people who convince you otherwise, thankfully! – sounds like the same convolutions that abused spouses go through to explain why their spouse is amazing.

NICUs don’t have “quotas”. No more than you have a “figure out how to maximize patient costs” requirement in the pharmacy. Do you have one of those? Is that why you are so busy knocking a different part of a hospital?

My son spent 4 months in a NICU that had 106 beds. The average census was 90 babies the first month he was there, followed by 80-88 for the remaining three months. The staff was thrilled. They had more than enough space to deep clean wards and had plenty of time to practice drills.

Since you work away from patients, let me tell you something; watching a chunky newborn start seizing from low blood sugar in the crib next to my son was one of the scariest moment of my life. Not because he was seizing – but because his mom had been sure that he didn’t need to be in the NICU and had been threatening to remove him.

MaineJen

Sorry, but what you went through sounds like torture and my worst nightmare. Yes, if someone is screaming in pain, it’s natural and compassionate to offer them pain relief, no matter what they may have told you the day before. People change their minds.

swbarnes2

Please explain in detail what Claire Teague remembers about her intervention-free birth. Or Caroline Lovell.

….

You won’t answer, because you are thoroughly dishonest.

Amazed

So if at 8 cm I am screaming that I want pain relief, you’ll pat me on the head and mumble comfortingly that overall, I don’t want this and harrass me until I mumble ” Yes, OK” just to get you off my back and then you’ll feel immensely proud that you’ve helped me achieved my desires and goals? That you’re focused on ME?

Fuck off… lady. I don’t take well to being held captive to what patronising creatures like you and your natural sisters convinced me wouldn’t be this painful when I had no idea what to expect would be.

Did you see this, dear everyone? Anjee B., with all the generosity of her heart, isn’t going to let you deviate from the plan she helped you devise in ignorance. No pain relief when you’re screaming that you want it. So nice that she admits it.

You’re right, Anjee. I’ll certainly always remember that your ilk tried to convince me that I didn’t feel as much pain as I felt.

Damned glad that you’re not my farmacist. Just three days ago, I bought pills to relieve period pain that should not be this important to relieve since hey, it isn’t an injury or illness if I ask you.

Get lost.

Abby

You are so anti epidural which makes me furious with you even though I don’t know you – how dare you decide how painful childbirth is for other women – I hate hate hate these stupid women who decide that because their labour was not too painful or long that the rest of us just have ‘low pain thresholds’ or are ‘too fearful’ about labour – just shut up and let other women do what they want – I’ve had a near fatal car accident with a lacerated liver and multiple rib fractures and I’ve had a baby – and my labour was much much worse than lying by the roadside with those injuries so you don’t get to decide based on your experience what interventions labouring women can have. I had an epidural eventually and a dural tear requiring a blood patch a few days later – so I had a complication and it was fixed , and I’m still glad I had the epidural. You have no idea the amount of PTSD and postnatal depression caused by people like you evangelising about natural birth and blaming women for their complicated painful deliveries so they are denied pain relief and mocked and belittled by midwives who all worship at the ‘natural birth’s altar (UK)

Plus – and I suspect Anjee is well aware of this – the rate of a major long-term injury to a low-risk woman from an epidural is exceptionally low. The total risk (which is still really low) includes some much higher risk women who have undiagnosed bleeding disorders, a bleeding disorder that developed rapidly (yes, I’m talking about HELLP) or previous spinal surgeries.

How do I know? I remember my stat anesthesia consult before Spawn was born. My platelets were far too low to allow a safe epidural at the time of the consult – but had rebounded enough 16 hours later for the actual surgery. Lots of questions about bleeding disorders and previous surgeries along with the standard questions about intubations.

Sarah

Tenner says it’d involve lots of ill qualified doulas.

LaMont

So, when my doctor scheduled a non-emergency endoscopy (under sedation – gasp!) on Thursday, the only day he was in the surgical center, that was evil and corporate because he was doing something according to his schedule, as opposed to nature (nature which would lead to me having unmonitored reflux and risk of esophageal cancer)?

momofone

Of course! If he REALLY cared about you and about being a professional, he would have waited until you presented to the ED in the middle of the night in crisis!

(sarcasm, of course)

LaMont

The fact that non-emergency c/s *being scheduled for when a team is awake and ready for you* is considered a bad thing is so transparent. Just say that women who want/need c/s (and know this before the day of the birth) are shitty mothers and too “corporate” to be part of the sisterhood in their small minds. The timing of the procedure isn’t the problem. Harping on it is just silly.

And personally, I prefer having surgery during the day. I’ve never seen any data to support the idea that non-emergent surgery done in the middle of the night has better outcomes for anyone. I doubt that data exists since outcomes for emergent surgeries are worse at night.

Amazed

Last night, Amazing Niece was dancing and jumping. Until she suddenly wasn’t. She started walking on her heels and when her dad tried to put her on the floor, she started shrieking. Her foot started swelling right before our eyes. Her parents immediately took to the ER in the middle of the night, the way it should be according to Anjee. All natural. The pain. The overworked staff. They were offered a cast for 10 days despite the X-ray not showing anything wrong because in bones so small, a tiny break could be missed. The next day, they went to her pediatrician who was rested and fresh, and made the kid walk and jump. The diagnosis came quickly accompanied by a gel and let me tell you, it wasn’t a broken bone. The kid is on the mend, dancing voodoo dances around us again.
The rested professional making the better decision. Can you believe this?

I bet you are loved by all the anesthesiologists at your hospital since you assume they have neither the interest or the skills to determine the relative risks of the patient who is requesting an epidural.

I enjoy the fact that you think an epidural takes a patient down to 0/10 pain – and that getting a patient to 0/10 pain is something a doctor should be ashamed of.

I love your swipe at NICUs; does that lessen the embarrassment of working at a primary money-making center within a trauma ward for you? Or are we just supposed to ignore that?

Cristina

My water broke Thursday morning but my son wasn’t born until Saturday because the doctors kept insisting on waiting for my induction to kick in instead of going straight to a C section. Even then, the OB insisted on letting the last induction sit longer than the previous 2. Turns out he knew what he was doing and I didn’t get a C section (despite wanting one by then). My GP ended up coming in an hour earlier than planned to be there for delivery. So much for my baby being born at their convenience…

MaineJen

“When needed or desired” So when a laboring woman desires an epidural, she should get one. Glad we agree!

MaineJen

“When needed or desired” So when a laboring woman desires an epidural, she should get one. Glad we agree!

Azuran

No one is saying pain medication should be used ‘all the time’ and it isn’t used ‘all the time’.
We are saying that anyone who wants/need it should get it and not get judged for it.
If you want to feel pain in labour, go for it. I, myself, desired an epidural as soon as humanely possible.
And just because childbirth pain comes from childbirth doesn’t mean it’s any kind of special pain that should get special consideration. It’s pain. Because a baby is ripping your vagina. If you want pain relief you should get it.
As for births being higher during the week days. What do you expect? Of course, every elective c-section and elective inductions are going to be scheduled during the week days, when there is more staff. And most will be planned the morning, so that most birth will still occur during the day. Because that’s when there is more staff, making it the safest time. Would you really want doctors to start planning elective c-section at 2am on a saturday?

Who?

Are you suggesting that pain medication is ordered ‘when needed’ and then administered without the woman’s consent? Because if the doctor orders it ‘when needed’ and the woman asks for it, where is the problem?

And thinking more about pain, how is labour pain natural in a different way from the pain of a broken bone? Why keep a patient comfortable in the critical stages of a bone injury ie while it is being examined and treated, and during the early hours and days after surgery, and not accord a labouring woman the same service?

Pain-free dentistry has revolutionised oral health-why is dental pain natural in a different way from labour pain, where relief from the first is considered a no brainer, but relief from the second is a failure?

What in the world is wrong with people making money by selling stuff others need or want. Birth hobbyists do it every day of the week, but doctors, nurses and hospitals do it and it’s a bad idea? That said, I agree with you that caring should not be a ‘for profit’ activity. However, the doors do need to be kept open, as provision isn’t free. I’ll take my surgical team awake, and having come to work just to look after me, thanks.

Nobody needs painkillers for setting a broken bone. They should be used only when needed or desired, which is not all the time. It’s just pain, right? Broken bones, while undesirable, are a perfectly natural thing to have happen and you can set and splint a bone without any painkillers whatsoever. No one died of having a bone set without painkillers, so obviously a man who breaks his arm is just a whiny baby if he asks for so much as a Tylenol to help him through it.

Madtowngirl

I actually did have a broken bone set without painkillers. I was 10, and I still remember every second, 25 years later. It still ranks up there as the absolute worst pain I have ever endured. I definitely would not recommend it to anyone.

Daleth

My issue is that the focus is not really on taking care of women with childbirth, it is on the convenience of doctors and hospitals. Why are so many babies born Monday thru Friday if this is not the case?

Because it’s safer. Hospitals are more fully staffed during the week than on weekends. The most dangerous time to be at the hospital is on a weekend night in early July, because in addition to the “skeleton crew” staffing levels, July is also when new residents arrive, so a lot of the residents are completely inexperienced.

That’s also why scheduled surgeries (including c-sections) are usually scheduled first thing in the morning on a weekday: because you get a full staff that’s completely fresh (shift just started). In other words, it’s the safest time to do surgery.

Daleth

Epidurals also have side effects and potentially fatal complications

Childbirth has side effects and potentially fatal complications. Life has side effects and potentially fatal complications. What’s your point?

Gæst

I mean, I guess we could say that women who are not in labor or otherwise experiencing pain should not seek to get one?

Daleth

Women should be uplifting each other and supporting WHATEVER informed decisions they make about pregnancy and chidbirth.

True–but are you maybe misinterpreting Dr. Tuteur’s post? The point of it is that there are a lot of people who are NOT uplifting women and supporting our informed decisions; instead, they’re telling us that there’s only one good way to give birth, and that way is vaginally, without pain relief, with a midwife instead of a doctor, and ideally at home. In other words, “naturally.”

If you want to uplift women and support their informed choices, you have to support women who want elective c-sections just as adamantly as you support women who want home births.

And since informed choices are impossible without real information, you also have to acknowledge the information that’s out there, which overwhelmingly shows that home birth in modern America is much less safe than hospital birth. Did you know that giving birth in a hospital with a CNM (Certified Nurse Midwife) is four times less likely to kill your baby, and seventeen times less likely to result in permanent brain damage to your baby, than giving birth at home with a home-birth midwife?

As someone who started out my pregnancy thinking that delivering at a birthing center sounded crazy and ended up having an absolutely amazing birth experience at a stand-alone birthing center run by an MD… this article is extremely negative about the very idea of natural birth, so I would say the author is most definitely not uplifting women who make choices that aren’t traditional high-intervention medical birth.

Also, I am not sure why you got really excited to tell me about home births as I never even mentioned that in my original comment. The link you shared is to an abstract/poster presentation. Though interesting, it is not completed research that was published as a peer-reviewed journal article.

Daleth

The link you shared is to an abstract/poster presentation. Though
interesting, it is not completed research that was published as a
peer-reviewed journal article.

Yes, it is. It was published in the October 2013 issue of the American Journal of Obstetrics and Gynecology. Most people don’t have a subscription to that, so I posted the link I posted, which everyone can access.

I’m glad you had a wonderful experience at a birth center. That’s great, but it doesn’t change the fact that twice as many full-term healthy singleton babies die in birth-center births as in hospital births.

Also, I have no idea what state you’re in (and am not asking, I don’t want to “out” anyone from anonymity), but it matters: some states have good regulations for birth centers, while in others (Oregon, I’m looking at you–but not only Oregon) you can pretty much open a birth center in your house with hardly any oversight.

A friend of mine’s first labor was spent in a birthing center in Pennsylvania, which has good regulations: CPM’s can’t practice there, only Certified Nurse Midwives, and birthing centers have to have agreements with hospitals to take transfer patients, which means the hospitals have some oversight. Good thing for my friend, who was transferred to a nearby hospital for an emergency c-section. That being said, last year the friends of a friend lost a healthy full-term baby at that same birthing center.

Michigan has a long history of having no regulations towards birth centers and midwifery – and an equally terrifying history of multiple neonatal deaths by midwives who are found liable under for wrongful death in the civil system (which is the only recourse for harmed parents), receive a major fine, file for personal and business bankruptcy, and then re-open.

Oddly enough, that factoid isn’t included in the “Pure Michigan” advertising campaign….

Daleth

A friend of a friend is a “lay midwife” in Michigan. Thanks to Facebook’s algorithms, when Michigan passed a law creating a licensing system for midwives, I was exposed to her idiotic lamentations about how her “profession was being made illegal.” Because it now had minimum educational standards that she couldn’t meet!

MaineJen

Side note: my husband is from Detroit, and ‘pure Michigan’ has become an inside-joke catch phrase between the two of us, for things that are truly messed up.

We use it to describe lead-tainted water created in a very short sighted attempt to save Flint money by an unelected, non-recallable state appointed city manager (Pure Michigan!), the fact that our roads manage to be continuously under construction AND in horrible shape at the same time (Pure Michigan!), and my favorite – the push every 10-15 years for the Upper Peninsula to become its own state (Pure Michigan!). Breaking the UP off into Superior State – which I concede is a catchy name – would create either the poorest state in the Union or second-poorest depending on the year.

Anjee B.

Thank you for mentioning when and where the full research was published, I happen to have access to things like that. I wasn’t trying to be a jerk when I mentioned your link was to a poster – as you probably know, many things published initially as posters don’t always produce robust results that lead to a real article – I was just making sure that wasn’t the case there.

There are strict regulations in my state based on how everything is conducted at the birthing center I used for my care. I forget that licensing for so many types of practitioners and providers varies so much from state to state and also the regulations with them, so I appreciate that reminder.

How many medical attendees were available at the MD stand-alone birthing center?

I ask because when my son had respiratory issues in the NICU the minimum number of people needed to effectively start newborn basic life support is three and a hard case needs 3-5 additional supporting staffers including an experienced neonatal respiratory therapist to get and maintain an airway.

This is in addition to whoever is still in charge of monitoring the mother postpartum and ideally one or more staff members to help the parents process and cope with seeing their baby code.

MaineJen

There’s no more zealous evangelist than the recent convert.

Amy Tuteur, MD

In your rush to malign modern obstetrics, you seemed to have missed the point of the post. The point is that when people want to manipulate women they accuse them of failing to fulfill their “natural” duties. Natural childbirth and lactivism attempt to manipulate women by using the same tactics employed by misogynists throughout history.

Anjee B.

I agree that manipulating women is bad.

I don’t see your post as being any better than my comments or “rush to malign modern obstetrics” since you are essentially maligning all providers and women who encourage or even choose natural childbirth. If your post was a bit more balanced in terms of acknowledging that many doulas, midwives, and lactation consultants actively seek to provide information and support for women regardless of what decisions they make, then that would be fine. Maybe I live in a place where the natural birth community is the exception and my views on this are skewed because of that, but every woman I met in my pregnancy journey was focused on uplifting whatever decisions I made. The birthing center MD even tries to basically talk everyone out of it (not really, but she asks a LOT of questions to see if each woman is serious about wanting a natural birth and whether or not it is a good fit for her.)

I have no trouble acknowledging that there are tons of amazing Ob/Gyns out there, the one who delivered my baby included, who are actually willing to provide a full spectrum of options and then support their patients through whatever choices they make. However, there are also tons of awful practitioners as well, who are the reason that modern obstetrics gets such a bad rap because they do all the bad stuff that results in women having terrible birth experiences, which mostly involves manipulating them into early or excessive interventions.

It would be lovely if you or any of your devout followers here could acknowledge the same spectrum exists among doulas, midwives, and lactation consultants.

Amazed

I see your post as infinitely worse, oh, Defender of Women. Since I don’t have children yet, I am not biased toward either side and I find your comments of how you won’t let me change my mind in labour horrifying. Dr Amy is offering choices; you’re offerring the removal of any choice but the one you have manipulated women into accepting.

I can acknowledge many things. But given each and every post of yours I have read this far, I’d say that every doula, midwife, and lactation consultant you recommend is someone unprofessional, biased, intolerant, criminally determined to keep women down a specific path, remove their chance to chance their mind once they get into the reality of their own situation. IOW, everyone you recommend should be avoided.

Oh, and since you mentioned capitalism… Come here, in post Communism, and try some of the healthcare in our countries. Then, we can talk.

OBGYNs have a medical board and licensing, and can (and do) lose their licenses for malpractice. They’ve been to medical school, done residency, and chosen this specialty.

Doulas and lactation consultants have no educational or licensing requirements. Most midwives either have no educational or licensing requirements or those requirements are an absolutely joke (seriously, I have no medical training, but I could pass the CPM test in less than 2 weeks of studying).

Quite frankly, a doula or midwife or lactation consultant simply isn’t as credible as an OBGYN. Are there OBGYNs who treat women abominably? Unquestionably yes. But they at least know quite a lot, and know enough to know what they don’t know. A non-medical person should absolutely not be trying to talk someone out of doing what an OBGYN recommends, but many do.

Childbirth is inherently dangerous and inherently painful. Bad things will happen sometimes, and sometimes the way we prevent people from dying is unpleasant and painful. But terrible birth experiences come more from unrealistic expectation than the actual interventions. PTSD is far more common from unmedicated childbirth than epidural’ed childbirth. PTSD and PPD are far more common from vaginal births gone wrong than births where a C-section occurs when things start looking shaky. To me, that suggests that it isn’t the interventions that are the problem. The NCB ideology is the problem, because it says that women who need interventions (and who would have died or been badly injured, or whose babies would have died or been badly injured in the past) failed somehow. That’s just asking to fuck someone’s mental health up.

I’ve never had kids, though I’d like to. I do know that I do NOT like pain. It’s not transcendant. It just fucking hurts. Why would anyone want to experience the pain of being literally ripped apart? I know some people do, but that’s just crazy.

namaste

Here’s the thing, Anjee…..sometimes life requires us to do something that sucks because it is in our best interests. Let me put it to you this way; I was born with a congenital heart defect, Aortic Valve Stenosis. When I was 9 years old, it became necessary to undergo surgery to improve my heart function. There are still a few more of those in my future. Did I want the surgery? Are you nuts? What 9 year old does? Did the experience suck? You bet it did. Am I alive today at age 30 because of it? Yes I am. So, on balance, am I grateful? You bet. And before you say “Pregnancy isn’t a disease!” You’re absolutely right. It’s more akin to an injury. A lacerated liver isn’t a disease, either. It’s still a medical event that requires recovery. Childbirthis much the same. It isn’t an illness, but it causes tissue trauma that takes time and rest to recover from.

Amy Tuteur, MD

What I’m asking people to do is to think deeply about the way that women have been manipulated by accusations that they or their behavior is unnatural. I’m asking people to consider that what they might view as a belief system they arrived at on their own was in fact fed to them by people who want to manipulate them for their own ends. As far as obstetrics getting a bad rap, almost all the criticism originates with midwives and doulas who are trying to claw back market share from obstetricians. Most women are quite happy with their maternity care. That’s why they resent natural childbirth advocates’ insistence that a birth experience is as important as the health of a baby. That’s why they resent pressure to avoid pain relief, pressure to avoid C-sections and pressure to breastfeed. It isn’t obstetricians who offer no choices; it is midwives and doulas who promote their own choices to the exclusion of everything else. That’s not merely unethical; it’s misogynistic.

fiftyfifty1

What I’m asking people to do is think deeply about the way that women have been manipulated by accusations that they or their behavior is unnatural.”

And I really want to thank you for the fact that you ask this question, and KEEP asking this question! I am a woman who had never strongly identified with being a woman or being feminine. And yet after the experience of my first baby (serious pelvic damage and a disastrous breastfeeding experience) I was left with this profound feeling that I was “unnatural.” Your posts all, in one way or another, encouraged me to think deeply about how I had internalized this shame. I am a better person, and a better doctor, for being able to realize and articulate what happened to me.

Amy Tuteur, MD

I’m so glad you found it helpful!

Azuran

I can say with absolute certainty that the 15 minutes before I had my epidural and the 20 minute before the 2nd one for my c-section where a hell of excruciating pain. In fact, it was the most pain I’ve ever been in. and I had on open double fracture.
But knowing that labour is painful didn’t make it painful. Letting women know that labour is usually extremely painful for most women is actually the feminist thing to do. When they know what to expect, they can better prepare and deal with it.
Seriously, what do you think is better?
A-Telling all women to expect a lot of pain, most expect pain and expected it, some are pleasantly surprised that they had less pain than they expected.
B- Hide the fact that childbirth will be painful for most of then, and probably the biggest pain that many of them ever felt. Then have some women who are lucky and don’t have much pain. But a large proportion of women end up surprised and unprepared for the pain.

Giving information is always the answer. Yet here you are, bemoaning that OBs are not respecting women yet saying we should hide from them the reality that childbirth is painfull

Gæst

When I was a teen, I had an appendectomy where no one told me how painful it would be afterwards (I assumed that the pain I was feeling before would be relieved by the surgery!) It was scary and I thought I was dying. Twenty years later I had an emergency c-section where no one really had time to prepare me for what that felt like, but having had abdominal surgery before I already knew. And it was so much better that way.

Anjee B.

I have no problem with women being prepared for whatever version of birth they choose, which will pretty much involve some pain regardless (whether natural birth or scheduled c-section which involves pain post-op). The problem I have is with the over-emphasis on pain to the point of making women terrified at the idea of giving birth. I also don’t agree with the tendency of women to tell each other horror stories related to pregnancy and childbirth – the narrative in the U.S. is pretty awful.

Yes, bad things can happen, yes, it is unreasonable to set women up to believe their experience will be awesome or positive or empowering no matter what – but it’s a damned shame to set women up to believe there is no chance of their experience being anything other than negative, painful, and scary. We all experience pain differently, there are different kinds of pain, and labor and childbirth are wildly variable in how they occur.

I am in no way suggesting that anyone “hide” the fact that childbirth is painful – I’m not sure where you get that impression? I agree that women should be informed, I just don’t think it needs to be done in a way that makes them afraid of childbirth from the first time they hear about labor as children.

Have you read any history at all? Childbirth has always been negative, painful, and scary. We estimate how many children a European noblewoman had by how how many times she updated her will. The pain and chance of death were so bad that some ancient peoples saw labor as a curse from god(s). Egypt had a hippo as a childbirth goddess- they did that because hippos are terrifying and can kill you dead on a whim, just like childbirth. Viking women who died in childbirth went to Valhalla, same as men who died in battle, because childbirth was as bloody and painful and scary and deadly as battle.

The ideal outcome- healthy mom, healthy baby- is fantastic. It’s worth the pain and risk by most people’s standards. But childbirth itself generally is an incredibly negative experience and always has been.

swbarnes2

So women who “choose” vaginal birth shouldn’t be prepared for c-sections? That’s your idea of good education? You prefer that midwives ‘educate’ women that if they do everything right, nothing bad can happen?

Azuran

Thing is, whatever birth a woman ‘chooses’ isn’t guaranteed to be the birth she gets.
The right thing to do is inform her of all the possible outcome so she can properly prepare for them.
Being somewhat afraid seems to me to be a perfectly normal and reasonable feeling toward anything that is both usually painful and potentially could lead to serious complication and death.
I understand not wanting to scare people, but it doesn’t seem to me that you can properly be informed about the potential risks and potential pain without also having some level of fear about the whole thing.

I believe everyone also has the right to tell others whatever experience (good or bad) they had during childbirth. Women who had negative experiences have just as much rights to talk about those as does someone who had her perfect empowering birth.

fiftyfifty1

So if I’ve had a bad experience with natural childbirth I should have to shut up about it? But If I had a good experience then I can talk? Why?

Jen

Great, then uplift and support my decision to have an elective c-section.

Anjee B.

Is there somewhere that I indicated that I would not support and uplift that decision? Do I understand it in most cases? No. Would I choose it for myself for any reasons other than medical necessity? No. The same way everyone here does not understand or have any interest in experiencing the natural birth that I chose.

BUT I do not need to understand a decision in order to support the existence of the option or the women who choose it. There are tons of decisions I don’t understand but I support the people who make them. Can you say the same?

Charybdis

I don’t understand the folks who breastfeed their child until the child is 2.5+ years old. To *me*, that’s just barking mad, as is the decision to bedshare, breastsleep, etc.

Sue

Hi, Anjee B.

Nearly everyone agrees that interventions should be limited to `medical necessity` but, in the absence of a perfect tool to predict, prospectively, which cases would be `necessary`, how would you choose which procedures to offer?

Imagine you are a health care provider, looking after women undergoing a process which is physiological and natural but, in which both mother and baby have a chance of dying without any assistance.

If you were held to account for the outcomes, how would you decide, without hindsight, when to intervene? Would you want to prevent significant harm, or would you wait for harm to be already occurring before you intervened?

As a health care provider myself, don`t have the luxury of hindisght, so I have to use the research evidence, which tells me that Cesarean birth is safer overall for babies, at the cost of a small increase of mostly-short-term risks for the mother.

That`s the point of view Dr Amy shares, along with many other health care providers who post here, and others who understand complex decision-making.

RudyTooty

Hello Anjee, I’m glad you posted. It makes for more interesting discussion to not have a silo of agreement. I’m sorry I couldn’t have responded earlier.

I know where you’re coming from. Not all women want medicalized births – and it can seem like women don’t have the option to have a natural labor and birth in many hospitals. No one likes to be coerced or demeaned.

What I think this post is getting to (or the way I’m interpreting it) is that women can also feel coerced and duped by the natural-birth-is-best industry, too. Yes. Some natural births are beautiful and manageable (defined by the person experiencing this labor and birth in their body). But to tell women that labor and birth IS beautiful and “empowering” and if it isn’t then they are failing somehow to fulfill their natural feminine function – well that’s pretty crappy.

A lot of the things you’ve described in your comments are things that I’d heard and believed about obstetrics and medicine – I heard them from midwives and natural childbirth advocates and doulas – but once I got experience working in health care – and worked in hospital OB units – I saw *some* of what you were describing, but really, it’s quite rare. The other thing I noticed was that most women weren’t clambering for natural births – they wanted epidurals. They wanted epidurals, and they were happy with their epidurals. And I couldn’t figure out what was so wrong about that. There really isn’t. (Just like there is nothing wrong with *not* wanting an epidural).

The misogyny, or patriarchy, or matriarchy – or whatever you want to call it – comes into play when other people decide what is best for others. If an OB/GYN decided every patient of hers MUST have an epidural (because that is the morally superior way to experience labor) well, that isn’t honoring patient choice. Same with a midwife who decides that every patient MUST not have an epidural (because that is the morally superior way to experience labor).

Empowerment, to me, means free of coercion. Blatant or subtle.
And feminism doesn’t imply conformity to any certain ideal, but the opportunity for self-determination. So if women are choosing “high-intervention” births, that is their choice, and therefore, feminist.

Anjee B.

Thank you for your comments. I genuinely appreciate your explanation and your thoughts, and the fact that you are not interested in insulting me or others who choose natural birth. Thank you also for not making assumptions or twisting my words to make me fit whatever overzealous views allow you then insult your presumptions of my opinions, as it seems many other comments have done.

RudyTooty

I do try to talk to people online like I would in real life.

We’re all people, here.

RudyTooty

I do try to talk to people online like I would in real life.

We’re all people, here.

Heidi

People are offended at you saying your way is the better way actually. Persecution complex much?

Amazed

Personally, I am angry at her assertions that she knows better than me what pain feels like to ME once she got me to stupidly accept her claims that it wouldn’t be THIS painful, so she feels completely justified to ignore me if at 8 cm I “break” and ask for epidural.

Who?

Did anyone insult you for choosing natural birth?

Some commenters were a bit insulting about your assumption that you know better than others not only what is good for them but what they really (or should) want. Given that your position seems to be that you don’t want to hurt anyone’s feelings, just to tell them that what they think they want is an incomprehensible thing to want, you might have expected some blowback.

What is insulting is accusing Dr T of being a dude in disguise (pretty rude to all the dudes out there who aren’t arseholes).

Sarah

People have judged you on what you’ve written. Don’t like it? Write different, less ridiculous things.

The Bofa on the Sofa

Really? You are complaining about insults? The person who called Dr Amy a “dude” because of her view on natural birth is fuckung whining about getting insulted because of her view in natural birth?

You are a piece of work, Anjee. Alas, you are also oh so typical of the clowns we get around here.

DoubtingDebbie

‘Pregnancy and childbirth are not diseases, they are natural processes’ – this to me is what is most offensive about your comments.

Tell that to my friend who gave birth to her first 14 weeks premature due to the ridiculous system that exists in my state whereby women are generally seen only by Midwives unless they can afford the considerable expense of a private obstetrician so no stitch was put in place to remedy her incompetent cervix. Second baby, with stitch in place came 5 weeks early and therefore did not have to spend months in the NICU.

Tell that to my other friend who suffered severe gestational diabetes during both of her pregnancies.

Tell that to another two who suffered hyperemisis gravidarum requiring more than one hospitalisation during their pregnancies.

Tell that to a relative who was on bed rest for months of her pregnancy with twins.

Tell that to my niece who was born via emergency Caesarian following her mother being in labour for over 30 hours, with my niece transverse and ultimately expressing a rapidly dropping heart beat in utero.

Tell that to my sister who like me cannot give birth vaginally due to a condition we have that has resulted in severe scarring in the ano-genital region which means vaginal birth creates a high risk of urinary and anal fistulas.

Tell that to at least 4 women I know who have had ectopic pregnancies.

Tell that to my parents, who had to witness me turn blue and be resuscitated following my birth at 40 weeks following induction, undersized likely due to placental deterioration.

I realise my anecdotes are not data, but your assertion that pregnancy and childbirth are not diseases but natural processes entirely misses the point. Pregnancy and childbirth carry huge health risks for many women. None of the women I have described would feel supported and uplifted by your anti-woman (if not anti-human) attitude.

EmbraceYourInnerCrone

I don’t understand people who equate “Natural” with safe or better. If we lived “natural” we would not use drugs for diabetes, for heart conditions, for asthma, we would not have blood transfusions or vaccines. People would “naturally” die in large numbers from measles, cholera, influenza, tetanus, burst appendix, allergic reactions, bee stings, malaria…
Death is perfectly natural.

space_upstairs

I think it started as a backlash against the discovery that certain artificial things – polluting factories, foods heavily processed with added fat and sugars and subtracted fiber and vitamins, certain medicines rushed to market or overused – were found to be causing at least as many problems as they solved. Eventually pursuit of the “natural” became a kind of secular religious principle and marker of upper middle class status, and if avoiding artifice altogether wasn’t possible, then the artifice had to avoid certain common (less classy) ingredients, as with common “x free” processed foods and supplements/alternative medicines.

The Bofa on the Sofa

I would add the reminder that disease is a perfectly natural process. You know what’s not natural? Curing disease.

The whole “Pregnancy is not a disease, it’s a natural process” is really lame on many levels.

space_upstairs

I’ve long felt it’s unnatural for me personally to try to live up to what society considers “natural” for women, regardless of whether those ideals are an expression of hostile sexism. I have been analytical and a science nerd from a young age, and was a late bloomer socially and emotionally, and never thought of the idealized stereotypes of the emotional, instinctive, intuitive, hyper-nurturing woman to be even feasible for me, never mind appealing. Which isn’t to say I can’t or don’t want to love or nurture or express emotions or whatever, just that it has to be on my own nerdy terms, and that I cannot see these things as ever being the be-all and end-all of my identity and existence, even when that so-called maternal instinct supposedly kicks in some 4 months and change from now. So I guess that’s why the prevalence and pressure of these “natural” norms around motherhood has only pushed me further away from them the closer I’ve gotten to being a mother.

Mari

Same here. Nothing makes me feel more uncomfortable when, at the end of a family meal, all of the female relatives suddenly spring into action and start clearing plates, offering to help with the next course etc while men stay in their seats. I know that when I don’t volunteer my own services in this situation (I sometimes do it when I want a quiet life, but it feels forced and ‘unnatural’), others are judging me. They probably think I don’t even KNOW that the ‘mothering’ role is expected of me, and assume I am simply ignorant due to being in some way defective. It’s a horribly uncomfortable position to be in, and I wonder how many other women feel it.

space_upstairs

I can’t say I felt judged, but I often found myself as the only woman not doing last-minute kitchen work at house parties, even in nerdy circles. And I think my non-domesticity has been great with my in-laws, as I don’t fight with them over who gets to organize and conduct the family party and the assignment of chores, I just ask what I can do if I think they need help. The toughest part is probably getting people to believe me when I say I don’t think I would enjoy breastfeeding, co-sleeping, or being cooped up with my kid for months on end. Or that I will not want a second child. It’s always, “you’ll change your mind when your hormones kick in, and not want your kid to be ‘alone’.” Even in nerdy circles.

Cristina B

Thanks for your comment. I’ve often felt like something was wrong with me or that I have emotional detachment issues for feeling the same way as you, so it’s nice to know I’m not alone. I like your in-laws. Mine absolutely judged me and criticized me. I’ve often chalked it up to an introvert vs. extrovert thing, but there may be more to it than that.

space_upstairs

I don’t think that not buying into the over-romanticized ideals of motherhood and being skeptical that they’ll suddenly be appealing after a child is born is a sign of emotional detachment issues. I think it’s a sign of just not having the most idealized sort of personality for your culture and gender, but society needs different kinds of people to function and adapt.

As for in-laws, I think that’s largely a function of family culture, and it just so happens that my being literally and figuratively from a foreign culture works to my advantage. My mother in law clashes a lot with her other daughter-in-law because they both want to run the show at family parties and vacations and be praised or admired for their social organization skills. It may be what assertive and outgoing wives and mothers generally do here, or it may be a strange coincidence. My husband and single sister-in-law argue that they’re effectively too much alike in the wrong ways. But both those strong characters get along fine with me because I have no such ambitions: I do not even think to compete for the coveted title of Family Matriarch. In another family culture, perhaps my lack of social ambition, initiative, or leadership within the family would be seen as a problem.

What is it exactly that your family culture seems to expect of you that you fail to live up to?

Cristina

At the end of the day, it seemed like everything and ultimately it’s why we aren’t together anymore. He was 11 years older and emotionally abusive so I’m not sure how much of it was family difference and how much was him playing both sides to his advantage. His parents have since passed on so I’ll never know.

My statement that I’m so glad whenever my son hits a new milestone because I get a little bit of my life and autonomy back went over like a lead balloon. Probably for the best they never heard me use my family’s term for a young infant – a human slug with less life skills than a real slug.

space_upstairs

Ouch. That’s another eyeroll-provoking thing: the notion of “wishing they would stay little forever” as a normative attitude to take about your kids growing up. I can enjoy spending time with little kids – I once spent a whole day playing with my niece when she was 1 1/2 as a kind of impromptu Mother’s Day present for my husband’s sister-in-law. It was fun but exhausting. Most people I know seem to have mixed feelings, in practice, about little kids, especially their own. But you’re always supposed to highlight the sappy side of your mixed feelings for some reason, and to favor youth, whether it be that of your kids or your own (as when you try to deny your age or get nostalgic about how nice it was to be young). I, for one, have said throughout my 30s that I don’t miss being young because I was much more foolish and more often unhappy then. And I imagine I will feel more proud than mournful or nostalgic when my own kid reaches major milestones of independence, like being born (pregnancy so far has been a mixed bag and the downs have been rough), sleeping through the night, playing quasi-independently, etc.

BeatriceC

I have frequently stated that in my opinion, babies and toddlers are necessary evils to get teenagers. I loved my own kids, but I really didn’t start really enjoying parenthood until they got to be around 9 or so, and I didn’t feel that “magic” that people talk about until they were about 12. I absolutely love parenting teenagers. They’re fantastic young people and watching them start to test the waters of independence and adulthood is really quite amazing.

MaineJen

*raises hand* I hate that. And I hate feeling silently judged for wanting to sit around after the meal, talking and picking at leftovers (‘with the men’) as opposed to doing the dishes right away.

Mari

It makes me feel like a freak, in much the same way that I’ve been made to feel odd for not cooing over babies. I’ve always wanted them, but not as pets, if that makes sense.

momofone

One of my relatives married a man from a family where the women and men didn’t even eat in the same room. The women served the men, served the children (yet another separate room, so as not to disturb the menfolk), then hurriedly served themselves and ate between trips back and forth to the other rooms. Because otherwise some man would have had to refill his own drink, or (gasp) check on the children, and that just could not be allowed to happen.

BeatriceC

The most amazing thing about MrC’s family, when we were a new couple, was the first Thanksgiving I had with them. All the people over about 12 who hadn’t helped with the cooking, ran off all the people who had helped with the cooking, so they could get all the clean up done. I was shocked to watch it because it happened regardless of what body parts the individuals possessed.

In my family, breaking into the ranks of the cooks (mostly males, but a few women, too) requires the death or major disability of one of the previous cooks. The guys take the turkey and fixings seriously; traditionally, they produce at least 3 stuffings, but occasionally double that….

seenthelight

Sounds like good parents raising those kids! That, or they clandestinely wanted to finish the leftover wine, as my dad told me recently he did as a teen… 😉

What was funny was when I was married, my mother in law, a lovely lady, used to ‘serve’ my father in law (also a lovely person). Well, they were born in the 1930’s, it was sort of the norm and I’m not passing any judgement on either of them. But my MIL apparently felt that my wife should ‘serve’ me in the same way (taking my plate off the table, etc) and when my ex wouldn’t, my MIL would take it upon herself to do it and give my ex the side-eye while she was doing so. Of course, this made me uncomfortable – I didn’t want anybody to be having to clear my plates or whatever so I would have to jump up pretty fast before my MIL could even have a chance to try. I don’t think my MIL ever got over the fact of thinking my ex wasn’t a ‘good’ wife for that reason. I mean, she WASN’T a good wife but that wasn’t why!

N

My husband is the cook at our house, and also knows how to clear plates and serve food. As soon as he knew me, he started on his own account to learn all this, because he didn’t want himself to end like his dad – doing nothing in the house, just sitting around, not even able to find the bread and salami for a sandwich without help – and me like his mother. So, from the beginning, when invited over to my husbands parents, after the meal, my husband and I equally sprang into action to clear plates etc. So did his brother with his wife. The amazing thing is, after a while, my FIL started to bring his own plate to the kitchen after meals too, as he watched his own sons help so much. It is never too late to learn.

I was raised in a family where the guys did the cooking for large family meals while women cared for small children. When there were only small children, the guys cared for the kids while the women cleaned up. Once the kids were old enough, we were dispatched to do clean-up while all the adults took a break.

I married into a family where the women do everything while the men sit around.

I asked my husband about it once and he justified it by stating that the guys were usually out farming – which makes sense in terms of why they weren’t cooking all morning – but makes no sense in terms of doing the last-minute set-up, clearing the table and cleaning up afterwards since the guys would just sit around and talk.

By the fourth year of our marriage, I had started showing up late specifically to avoid the worst of the chaos of setting up. I didn’t mind the idea of being “inappropriate” by refusing to set up – but not helping when the hostess’s ADD meant that the entire process was in a state of massive chaos was stressful. Ofc, helping out was stressful because the hostesses were always one of a set of sisters who have unique family traditions must be maintained even when they no longer worked. (A minor example was that the family filled half of the drinking glasses with water and the other half with a pre-made sugary punch. The problem is that only 3 people out of 30 could drink the punch so everyone else was simply SOL.) I was always assigned the job of setting up the pickle dish (which involved multiple dishes and a detailed discussion about which dishes they should use this year – beginning 20 minutes or so after the time people were told the meal would be served). I also managed to set up the pickle dish(es) incorrectly every year. See, there’s some method for deciding which type of pickles go where – but all I’ve ever figured out is that no matter how I do it, it is wrong. (Perhaps that IS the method…)

Don’t ask about how my decision of putting labels in front of the types of cheese on the cheese sampler on the appetizer tray was received. Also, I brought different crackers. I think birthing a son has redeemed my status a bit – but I’ll never be the daughter-in-law they wanted….thank God.

Steph858

Anyone who tries to convince me of anything on the basis that “It’s natural” is told to go to the nearest woods and eat as many random berries and mushrooms as they can find. THEN they can come back and carry on extolling the virtues of nature.

space_upstairs

I actually heard once about some raw vegan hippie type who died eating the wrong wild mushrooms. It is a good point, that most people who embrace the “natural” tend to do so in a very limited way, and it seems often only because they have this idea that excising the “unnatural” from their lives will somehow ease their daily physical or psychological complaints. And they probably got this idea from their friends and acquaintances…yet, everyone is a self-declared nonconformist and is fighting against the Machine that everyone else but they and their enlightened friends still conforms to. I feel almost more of an outsider for admitting that I’m a conformist and that my left-of-center politics and my pescetarian diet were heavily influenced by my social milieu…as is my stance against nature-worship in matters of body care, given that I’m a scientist with a number of prominent friends and acquaintances drawn to the Skeptic community.

guest

I have a lot of the same traits as you. A few weeks after my first was born, my husband commented that it was surprising to see me acting so maternal and that he never pictured me being so caring and nurturing. I said something like what did you think I would do, put the baby in a corner and forget about it?
I think it’s a pretty basic human instinct to care for a helpless baby, regardless of gender I never felt especially close to my babies, but I always felt responsible for caring for them. At 4 and 7, they are stuck to me like Velcro so I must have done something right…or something wrong???
Just parent however feels right to you and you will all be fine. Your kids won’t know any different.

space_upstairs

My husband has no problem picturing me as a loving and devoted mother, given how affectionate I can be with him, but my family has always thought he’ll probably be better with the baby because he tends to express his affectionate side more publicly and make fewer snafus with handling baby nieces and nephews (like when I let my nephew’s pants fall down). I figure that I’ll probably handle raising my kid fine, but I will likely have to swim against the tide a little. I’ve been preparing myself to do so.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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